A retrospective study of patellar realignment procedures was performed on patients over the age of 30 years, with a mean follow-up of 32 months on 16 operated-on-knees in 14 patients. The best results were achieved in patients with preoperative apprehension and compression signs, as well as a typical history for patellar subluxation. when these signs were absent after operation, the result was better than seen in patients whose clinical signs persisted. There was no correlation of results with the grade of chondromalacia noted at surgery. Good or excellent results were achieved in about 75% of the patients. An accurate preoperative diagnosis in the selection of operative candidates is imperative.