Does the patellofemoral joint need articular cartilage?—clinical relevance

The patellofemoral joint (PFJ) is enigmatic and we know the pathomorphology for anterior knee pain (AKP) is multifaceted. This paper review alignment and biomechanical factors associated with AKP both in the younger generation with or without cartilage changes and discusses the importance or obscurity of cartilage in the PFJ pathoanatomic changes such as trochlear dysplasia (TD), patella alta, increased femoral anteversion, lateralized tibial tubercle, external tibial torsion and valgus deformity affects the patellofemoral articulation. In order to achieve effective and durable results, it is of importance that any significant deviation in patellofemoral alignment should be corrected by realignment surgery, before considering cartilage procedures in the PFJ Patellofemoral alignment factors in both the frontal plane, the transverse plane and as well as the sagittal plan needs to evaluated thoroughly by not only clinical examination and X-ray, but also by MRI scans or CT scans.