Orthopaedics, August 2004

"This paper examines the relationship between rotational malalignment of the lower limb and patello-femoral pain. In particular, the researchers address the 'miserable malalignment syndrome,' which consists of coexisting internal torsion of the femur and external torsion of the tibia. They review 14 patients with 27 limbs exhibiting this syndrome and patello-femoral pain, all of whom failed conservative treatment. Patients averaged 85� of internal hip rotation and 33� of external rotation."