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The patella is your kneecap, and the femur is your thighbone. To keep your kneecap in place, there are several tissues surrounding it and connecting it to your femur. If you’ve suffered an injury or your muscles pull on your kneecap and create strain, you might experience pain.

Patellofemoral pain syndrome happens when the tissues attached to your kneecap are too tight. They can pull your kneecap out of place. Patellofemoral release surgery is a procedure that loosens these tight tissues and lets your kneecap move back into place.

Patellofemoral release surgery is often a last resort. Your doctor may only recommend this surgery after non-invasive treatments — such as bracing, physical therapy and activity modification — don’t reduce or relieve your symptoms.


In many cases, PFPS is caused by vigorous physical activities that put repeated stress on the knee —such as jogging, squatting, and climbing stairs. It can also be caused by a sudden change in physical activity. This change can be in the frequency of activity—such as increasing the number of days you exercise each week. It can also be in the duration or intensity of activity—such as running longer distances.

Other factors that may contribute to patellofemoral pain include:

  • Use of improper sports training techniques or equipment
  • Changes in footwear or playing surface


  • Pain on the front of the knee, under the knee cap, and sometimes on the sides of the knee
  • Pain is often aggravated by prolonged sitting and climbing down stairs
  • Clicking or grinding may be felt when bending the knee
  • In some cases the knee may give way with weight bearing (due to pain inhibition of the quadriceps)

If your patellofemoral syndrome doesn’t respond to over-the-counter and at-home treatments, a doctor may recommend surgical intervention. Examples of surgical interventions for patellofemoral syndrome include:

Arthroscopy: This procedure involves a surgeon inserting a camera into the joint to remove damaged cartilage. The doctor can also release tendons that are too tight and pull on the kneecap to allow it to move in the groove correctly.

Tibial tubercle transfer: This process involves realigning the kneecap. A doctor will move the tibial tubercle, which is the bony portion of the shinbone, as well as the patellar tendon to improve the knee’s alignment.

Most often, these treatments aren’t necessary. However, if your pain gets worse with time or never resolves with conservative treatments, see our physician to discuss your options.