This is a combination of rotational deformities that may lead to patellar (kneecap) pain and instability. Usually the femur is rotated outwards, but the tibia rotated inwards, and the kneecaps face towards one another (squinting or winking patellae).


Fifty years ago, Dr. Hughston, one of the founding fathers of American Sports Medicine, imparted a vernacular term for rotational deformities of the lower extremity – “Miserable Malalignment.”


Discussing rotational problems with the log bones of the leg and how they can affect the kneecap.

Conditions interfering with patellofemoral mechanics

Part 4a of a course on Patellofemoral Pain by Dr Ronald Grelsamer of Mount Sinai Hospital in New York.

Part of a course by knee surgeon, Dr Ronald Grelsamer.