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A syndrome of patellofemoral dysfunction, consisting of painful popping, catching, grinding, or jumping of the patellar component, can complicate total knee replacement. From October 1983 to March 1988, eleven of 635 total knee replacements had this syndrome. On arthroscopic evaluation, the dysfunction of the patellofemoral articulation was found to be secondary to intra-articular fibrous bands. In eight patients, a transverse fibrous band prevented the patella from seating well in the sulcus of the femoral component. In four patients, the fibrous band extended from the superolateral border of the patella to the infrapatellar fat pad, tethering the patella laterally. In one patient, the fibrous band extended from the distal pole of the patella to the intracondylar notch, tethering the patella inferiorly. In all patients, the symptoms resolved after arthroscopic removal of the fibrous bands.