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Patellofemoral instability and patellofemoral pain are seen commonly in the outpatient setting. An understanding of knee anatomy and accurate interpretation of clinical findings are necessary to evaluate and manage patellofemoral pain and instability properly and to help young patients return safely to sports. In this article, we discuss how to distinguish patellofemoral instability from patellofemoral pain and offer our approach to managing these conditions.

Patients who have increased hip internal rotation, lower leg external rotation, knock knee alignment, flat foot, tight hamstrings, tight heel cords, and poor quadriceps muscle tone are at increased risk for anterior knee pain. This condition is referred to as patellofemoral or anterior knee pain syndrome. The previous term, chondromalacia patella, has fallen out of favor because it refers only to the anatomic changes of the undersurface of the patella and not to the soft tissue or...

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