Etiopathogenesis: It is the most common cause of anterior knee pain. It is seen in every one woman in five in our country. It is more commonly seen in patients who sit and work for long hours and who are overweight. It is the degeneration of patellofemoral joint cartilage. In contrast to osteoarthritis, pathologic process starts from the deeper layers of cartilage surface. In latter stages, superficial layers are affected. Cartilage surface continuity is preserved, but the cartilage becomes softer. Etiologies include trauma (patellar fracture, patellar dislocation, etc.), biomechanical problems (alignment problems, increased q angle, patella alta), degenerative pathologies (primary osteoarthritis), systemic diseases (rheumatoid arthritis, recurring hemarthrosis, etc.) or iatrogenic causes.

Clinical Status: The chief complaint is anterior knee pain which occurs especially after sitting for long hours or climbing stairs. Decreased daily activity due to pain is another complaint. Rarely, knee swelling or locking may occur.

Diagnosis: Generally, in patients with long term complaints, irregularities may be seen in knee x-ray when they are scrutinized. Definitive diagnosis can be made with MRI.

Treatment: Primary treatment is lifestyle modification, activity modification and weight loss. Patella stabilizing knee pad, NSAID treatment, quadriceps strengthening exercises and hamstring stretching exercises may be beneficial as conservative treatment. For patients who don’t respond to 3-6 months of conservative treatment, correction of extensor mechanism alignment problems (medial plication/lateral release, tibial tubercle osteotomy) and cartilage-oriented surgeries (arthroscopic patellar shaving, drilling of the defect that reaches subchondral bone, facetectomy, tibial tubercle proximal relocation, patellectomy, patellofemoral surface arthroplasty) may be needed.