Patellar chondropathy (PCH) is very often diseases in every age, which have many distinct and obscure causes. Between 1990 and 2005 520 patients (354 male - 68,2% and 166 female - 31,8%), of average age 35 (17 - 80) have been investigated and operated using elaborated surgical algoritm. The time elapsed from the PCHhy beginning was approximately 36 months (1-360). The clinical, radiological, biomechanical, MRI and arthroscopical methods were used. The patients were evaluated in 24 month using 2000 ICDS score. Algorithm for investigate PCH include: 1st STEP -assessment of history, 2nd STEP - assessment of etiology, 3rd - STEP - assessment of anatomical status, 4th STEP – assessment of biomechanical situation, 5th - STEP - assessment of inflamation, 5th - STEP – assessment of functional status. 6th STEP – DIAGNOSIS. Algorithm for surgery PFJ with patellar chondropathy is following. 1st STEP. Shaving , drillng ( mikrofracture), massive irrigation. 2nd STEP. PFJ congruence recovery with lateral hyperpressure (Proximal realignment - lateral release, vastus medialis obliqus advancement, medial tightene, patellar tenodesis. Distal realignment - soft tissue surgery: medial transfer the lateral half of the patellar tendon (skeletally immature); bone tissue surgery: tibial tuberosity medialization). PFJ congruence recovery without lateral hyperpressure (tibial tuberosity proximalization; tibial tuberosity distalization). 3rd STEP. Sagital decompression of FPJ (tibial tuberosity ventralization). Using this algoritm the follow-up were scored: 71,9 % - A, 23,4% - B, and 4,7% - C.