Sulcus-deepening trochleoplasty may result in a serious patellofemoral incongruence in cases where the patella also is highly dysplastic. In such cases, a closing wedge osteotomy of the patella may be considered. The technique was used in two patients (both female, 16 1/2 and 14 years old respectively) out of 85 trochleoplasties performed. At two years follow-up, both patients showed a stable patella with correct tracking. Both considered their functional result as excellent. Postoperative radiographs showed a normal sulcus angle (135 degrees and 132 degrees) with good congruence. Closing wedge patellar osteotomy, combined with sulcus-deepening trochleoplasty, can increase patellofemoral congruence with good clinical outcome.