Despite the explosion of patellofemoral knowledge and surgery, one classic risk factor (patella alta) remains central to our surgical approach for patellar stabilization. The main surgical intervention for the correction of patella alta is to distalize the tibial tubercle, thus normalizing patellar height. The Caton-Deschamps index is a common method for measuring patellar height and has the advantage of being a valid measurement both pre- and postoperatively. This commentary will discuss current issues surrounding the measurement of patella alta and how Caton-Deschamps index remains an accurate and practical way to measure patellar height pre- and postoperative distalization of the tibial tubercle.