Patella infera (baja) may develop after monoplanar applications of medial opening wedge osteotomy (MOWO). Gaasbeek et al. demonstrated that the applications of an osteotomy technique in which the tibial tubercle is left in the proximal fragment in MOWO prevents the formation of patella infera. Lobenhoffer et al. found that the applications of biplanar osteotomies in patella infera cases prevents the changes in extensor mechanism after the osteotomy. This was possible by directing the bone incision behind the patellar tendon downwards rather than upwards. In the follow-up studies, the osteotomy applications in which the tibial tubercle was left either in the proximal or distal fragment were compared. It was found that the proximal application did not change the length of the patellar tendon in the proximal fragment and therefore prevented the progression of patellofemoral osteoarthritis. The experiences of the authors also support these findings. If there is no patella infera before the surgery, osteotomies in which the tibial tubercle is left in the proximal fragment do not change the patellar tendon length.