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@@ Introduction Patellar problems art; frequently encountered in knee surgery clinics.The patello- femoral joint has a low degree of congruency. Its passive stability depends on: 1. Bony structures: patellar and trochlear shape; 2. Soft tissue structures: quadriceps muscle in particular the vastus mcdialis ?VMO), lateral and medial retinaculum, medial patellofemoral ligament (MPFL).