Chironic patellofemoralchiondromalacia

The evaluation and treatment of patients with symptoms secondary to an abnormality of the patellofemoral jointis dependent on an understanding of the biomechanics of this joint along with performance of a meticulous history and physical exam. angential views of the patellofemoral joint and additional imaging studies, particularly computerized tomography, can at times provide a better understanding of the underlying abnormality. ost conditions can be treated nonoperatively.Surgery is usually reserved for those patients with persistent symptoms despite nonoperative treatment, and must address the underlying pathology and abnormal biomechanics if present. rthrosis of the joint may occur in the presence or absence of a malalignment pattern, and when malaligned the physician must distinguish whether there is tilt, subluxation, or both. ilt can result in rapid deterioration of the lateral facet and usually responds well to lateral retinacular release. hen tilt occurs in conjunction with subluxation the results of lateral release are compromised. Subluxation by itself is usually best treated by a proximal or distal realignment procedure. Arthroscopy has a limited. role in the treatment of advanced chondrosis and consideration can be given to anterior or anteromedial advancement of the tibial tubercle. atellectomy remains a salvage procedure for patients with severe patellofemoral arthritis but should only be performed in a normally aligned extensor mechanism.