My wife is 58 and has bone to bone contact between her femur and
patella.  Her patella is also 'tilted' towards the outside of the knee
due to the absence of cartilage.

The consultant has recommended that the following procedures should be
carried out:

1./  Microfracture of the trochlea, to allow bone marrow and stem
cells to seep through and grow a 'cartilage' type tissue over the
bone.

2./  Abrasion anthroplasty of the patella.

3./  Lateral retinacular release of the patella to correct the 'tilt'
and also to to relieve pressure on the new 'cartilage'.  

We would be very grateful to receive comments or advice regarding
their experience or knowledge of above, either directly by email or
posting to this group.

In particular, we would greatly appreciate comments on lateral release
as we understand that it is hard to correct if it goes wrong and the
outcome does not always appear to be succesful.

Many thanks,

Ron