In brief: Knee pain relating to or arising from the patellofemoral articulation is common in athletes. While direct trauma can cause this pain, patellofemoral malalignment and/or tracking problems seem to be its major source. This paper reviews the functional anatomy of the patella and describes the diagnostic and treatment procedures recommended for investigating and treating this condition. Most patients improve after an initial course of conservative treatment. Proximal or distal realignment may be surgically performed in patients who don't respond to conservative treatment. Patellectomy leaves some weakness in the quadriceps and should be used only as a last resort.