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For patients who dont respond to 3-6 months of conservative treatment, correction of extensor mechanism alignment problems (medial plication/lateral release, tibial tubercle osteotomy) and cartilage-oriented surgeries (arthroscopic patellar shaving, drilling of the defect that reaches subchondral bone, facetectomy, tibial tubercle proximal relocation, patellectomy, patellofemoral surface arthroplasty) may be needed.

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