Patellar malalignment: a treatment rationale.

A general review of present-day treatment for patellofermoral malalignment is presented. These regimens are viewed in light of known anatomical, biomechanical, and pathophysiological principles. We stress the need for a sound knowledge of biomechanical and pathophysiological principles prior to the initiation of surgical or rehabilitative techniques. Three major categories of surgery are discussed: 1) simple lateral release, 2) proximal "dynamic" realignment, and 3) distal patellar tendon realignment. A comprehensive rehabilitation program is presented based on sound biomechanical principles and known surgical techniques. We wish to stress the "non-surgical," conservative approach to patellofemoral malalignment through the use of a well-orgainzed and structured rehabilitation program.