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Patellar malalignment

Patellar malalignment is present when the kneecap runs too far to the side of the groove in the underlying femur bone into which it slides when the knee is bent and straightened.

Usually such malalignment is to the outer (lateral) side as the tissues here are sometimes too tight and the tissues on the inner (medial) side insufficient to balance the forces and keep the kneecap in the middle of the groove.