Arthroscopy of the patellofemoral joint.

There are multiple causes of patellofemoral pain that can be difficult to differentiate. A careful history and physical examination along with appropriate radiographic evaluation lead to the correct diagnosis in most cases. Most patients respond to a comprehensive nonoperative program that emphasizes stretching and strengthening of the quadriceps mechanism. Arthroscopy should be used judiciously when approaching patellofemoral problems. Regarding alignment, arthroscopy offers little benefit but may provide visualization for lateral release to relieve tilt. Arthroscopy of the patellofemoral joint does provide valuable information about articular cartilage breakdown location, extent, and pattern, which may help with future treatment decisions. Arthroscopy is helpful in the diagnosis and treatment of plicae and in ruling out other intraarticular causes of knee pain.