The goal of this randomised controlled trial is to compare a tuberositas transposition (TTT) surgery with a home exercise program (HEP) in patients with patellofemoral pain syndrome (PFPS). The study aims to evaluate the efficiency of TTT in conjunction with a HEP compared to a HEP alone in patients with chronic PFPS.

Participants will randomly be allocated to the surgery or HEP group. Researchers will compare the surgery and HEP groups to see if activity-related pain and patient reported outcome measures (PROMs) are different.

Inclusion Criteria:

• Characteristic history of PFPS (patellofemoral pain during knee loading physical activity, such as jumping, running, squatting);
• Symptoms lasting at least 12 months;
• Tibial tubercle trochlear groove (TT-TG) distance of 15mm or more on CT or MRI;
• Patellofemoral pain during daily life activities, such as: standing for an extended period, walking, or walking upstairs or downstairs

Exclusion Criteria:

• Previous knee surgery;

• Reported knee ligamentous or meniscal injuries;

  • Disabling general illness;
  • A history of patellar dislocation; however, subjects with patellar subluxation are included in the study;
  • Other knee problems than PFPS diagnosed clinically (such as jumper's knee);
  • Other knee problems than PFPS diagnosed radiographically (such as osteochondritis - dissecans);
  • Patients who cannot undergo surgery;
  • Pregnancy;
  • Patients with inability to complete follow-up or with limited understanding of the Dutch language

The trial protocol is available from the corresponding author on reasonable request. Data will be handled according to the FAIR principles. After completion of the study, metadata will be available upon request. For access to participant level-data and statistical code, an application can be submitted to the corresponding author.

After publication of the results of the study in a scientific article, data will become available for 15 years.

Reasonable request.