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8, P=0.001). Lateral patellar tilt also increased with increasing lateral position of the tibial tuberosity at 30° for the non-alta group (r =0.55, P=0.04). For patients with patellar instability, lateral patellar maltracking with the knee extended can be largely attributed to either a shallow trochlear groove or a combination of patella alta and a lateral position of the tibial tuberosity. These relationships should be considered in both conservative and surgical treatment planning. For patients with patellar instability, lateral pate