The majority of patients with chronic Patellofemoral Syndrome can be effectively treated without surgery. However, surgery may be necessary in some cases particularly if there is actual fraying and damage to the underlying patellar cartilage. Your surgeon or physician may recommend arthroscopic surgery to assess the extent of the injury and smooth the surface of the cartilage. Other surgical procedures – such as a lateral release – can help if excessive lateral tracking causes your PFS.Physical therapy can be quite helpful and may incorporate exercises, taping and orthotic fabrication.