Classification of Fulkerson and Shea for Malalignment in a Patient with Chronic Patellofemoral Pain

Original Editor - Ajay Upadhyay

Top Contributors - Laura Ritchie, Ajay Upadhyay, Kim Jackson, Daphne Jackson and Wanda van Niekerk  


Fulkerson and Shea reported a grading scheme for classifying patellofemoral malalignment in patients with chronic patellofemoral pain. [1] The authors are from the University of Connecticut.

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Intended Population

Patients with chronic patellofemoral pain.

Method of Use

Parameters: (1) patellofemoral malalignment (2) articular lesion

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• Minimum chrondromalacia corresponds to Grade 1 or 2 articular damage (see arthroscopic grading scheme for degeneration of articular cartilage). • Osteoarthrosis corresponds to Grade 3 or 4 (large areas of fibrillation or exposed bone.


  1. Fulkerson JP, Shea KP. Disorders of Patellofemoral Alignment. J Bone Joint Surgery. 1990; 72-A: 1424-1429
  2. kncps. Subluxation with patella alta (Australian site). Available from: [last accessed 12/09/14]