Chondromalacia patellae is a pathologic diagnosis. The initial diagnosis is patellofemoral pain syndrome, unless actual evidence of chondromalacia is available. The success of a nonoperative treatment program is correlated with improvement of thigh musculature balance. An arduous muscle-strengthening program is part of the treatment protocol. Only eight in a series of 100 patients required surgery. The physician's attitude and the patient's confidence are important elements in the success rate.