Participants will receive the Mikhled Knee Exercise Program (MKEP) three times per week for 6 weeks under physiotherapist supervision. The program includes wall slides, step-downs, eccentric decline squats, lateral step-ups, terminal knee extensions, single-leg stance with trunk rotation, and quadriceps isometric exercises (2-3 sets of 10-15 repetitions), with progressive advancement based on individual tolerance. In addition, participants will receive Stecco Fascial Manipulation for 10-15 minutes, 1-2 times per week, targeting the Centers of Coordination (CCs) of the hip, thigh, and knee to improve fascial mobility, reduce pain, and enhance knee function.

Participants in Group B will also perform the Mikhled Knee Exercise Program three times per week for six weeks, following the same structure and progression as Group A. This includes the same set of functional and strengthening exercises aimed at restoring proper patellar alignment and improving knee function, such as wall slides, step-downs, eccentric squats, lateral step-ups, closed-chain terminal knee extensions, single-leg stance with trunk rotation, and isometric quadriceps holds. Exercise intensity will begin at two sets of 10 repetitions and gradually increase to three sets of 15 repetitions, with resistance and complexity progressing over time based on the patient's response