The prevalence of osteoarthritis of the knee is very high in the elderly female population. The prevalence of knee osteoarthritis is about 56-68% in the elderly female population around the age of 60, according to different statistics. This rate is higher with increasing age. As osteoarthritis of the knee develops, the disease will lead to pain and recurrent swelling and fluid accumulation in the knee joint, which will gradually worsen and eventually lead to limping or even inability to walk normally, affecting normal life. But why is there such a high incidence of osteoarthritis? In fact, not all knee pain, especially anterior patellofemoral pain, is due to osteoarthritis of the knee. However, the reason why patients end up developing early osteoarthritis is because the treatment of the disease is neglected when patellar tenderness is present. The knee, being a three-compartment joint (patellofemoral interval, medial tibiofemoral interval, and lateral tibiofemoral interval), actually does not accumulate osteoarthritis in all three compartments. It has been found that osteoarthritis first appears in the patellofemoral joint and then progresses to multiple compartments, developing into a multicompartmental osteoarthritis that includes the patellofemoral and medial tibiofemoral joints. Multicompartmental osteoarthritis represents a more advanced stage of the disease. When the disease reaches this level, surgery becomes the preferred option. So, how does patellofemoral osteoarthritis develop? There is growing evidence that chondromalacia patellae is a pre-presentation of osteoarthritis of the patellofemoral joint. Patellofemoral chondromalacia simply presents as worn and chapped patellar cartilage. Anterior patellar pain occurs when the patient climbs hills, stairs, or squats for a long time and then climbs stairs or stands up from a stool. Since the symptoms are often not serious, most patients choose to tolerate or ignore them, hoping that “they will get better after a while”. In fact, chondromalacia patellae does not heal on its own. However, it can be cured. Professor Xiao Jun of the Department of Joint Surgery of Southern Hospital has been working tirelessly for a long time to explore and improve the treatment of chondromalacia patellae. From the clinical follow-up results available so far, the efficacy of chondromalacia patellae is very precise, and most patients have their symptoms and signs disappeared about 2 years after surgery, reaching a complete clinical cure. For those who choose to tolerate the pain or hope that “they will get better after a while”, it is important to point out that —- patellofemoral chondromalacia will progress to osteoarthritis of the patellofemoral joint in about 2 years. Once it develops into osteoarthritis, the effectiveness of medication will take a sharp turn for the worse. Even if you make an effort to adhere to treatment, you are only slowing the pace of osteoarthritis disease progression, and medications will no longer be able to completely cure the disease. Therefore, chondromalacia patella, as the “first signs” of osteoarthritis of the knee, must be taken seriously. For female patients around 40 years of age, or those with special jobs that require frequent squatting, climbing and stairs, it is important to be highly alert for pain in the front of the patella and seek medical attention as soon as possible.