Patellar maltracking and proximal and distal patellar insertional stress

I’ve attached 2 related Knee MRI I’ve seen in the last week

I had always assumed that Osgood Schlatter resulted in patella alta, but the first case has superimposed trochlear dysplasia, which argues against acquired patella alta.
The second case, without any findings of previous Osgood Schlatter has patella alta and a shallow trochlea.
I know that Adults with a history of Osgood Schlatters are at high risk for patellar maltracking, but this makes me wonder if that’s an association rather than causation.
Does underlying patella alta and shallow trochlea predispose to traction stress injuries to the origin or insertion of the patellar tendon….independent of any history of Osgood Schlatter disease?

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