In an effort to evaluate the use of a transverse incision and a relatively small elevation (1.25 centimeters) of the tendinous insertion of the patellar ligament into the tibial tubercle, 184 patients were treated with a modified procedure using the Maquet principle. The indications for the procedure were patellofemoral pain and loss of active function. The patients were placed in five groups based on the cause of their symptoms: chondromalacia, patellofemoral arthritis, patellar dislocation, previous trauma, and previous patellectomy. The results were evaluated on the basis of whether or not primary wound-healing was satisfactory and whether or not the patient resumed the ability to ascend stairs and could engage in previously lost athletic function, Eighty-five per cent of the patients achieved these goals of treatment. The disadvantages of the procedure appeared to be the slow return of full function (averaging six months), prominence of the area of the tibial tubercle, and persistence of crepitus on patellofemoral motion.