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Patellofemoral maltracking, or patellofemoral pain syndrome, is an imbalance in the gliding of the kneecap. A maltracking patella is moving laterally during knee flexion while it moves upward in the trochlea groove. This may result in knee pain and swelling. Patellar maltracking, when present, should be addressed to reduce overloading of the lateral patellofemoral joint and reduce the risk of future cartilage injuries. Since the recognition of medial patellofemoral ligament (MPFL) as an important medial stabilizer of the patellofemoral joint, numerous surgical techniques have been described ranging from repair, imbrication (reefing) or plication of the medial retinaculum done by open or arthroscopic techniques. Arthroscopic medial reefing is a minimally invasive procedure indicated in cases of failed conservative management, requires a meticulous postoperative rehabilitation program and has fairly good clinical outcomes.

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