First of all, I have little knowledge of the anatomy of the knee, so apologies in advance to any poor terminology or descriptions

In November of 2010, I fell directly onto my right knee cap onto concrete with my knee bent at a right angle. The knee swelled up and bruised a within a few hours and was increasingly painful. I saw a doctor and an x-way was ordered, which was assessed and I was cleared of any serious injuries. I was told I had "probably damaged some cartilage" and was advised to see a physiotherapist, who I had frequent sessions with for about six months. The physiotherapy didn't make a great difference and I have put up with minor pain for the last year and a half.

A couple of weeks ago I started to experience significant pain in my knee, especially when using stairs or when walking up and down hills. When I swing my leg whilst walking, it is quite painful and feels as though my knee is going to give out or pop. I also feel this when lifting my leg and experience a sharp pain when putting weight on my knee whilst it is bent (squatting, standing up etc.). My knee is swollen, very tender and my kneecap is very painful when touched. I can feel something that is circular in shape around my kneecap that I cannot feel in my left knee (could be the fat pad?) and this is also very painful when touched. When I place my hands either side of my kneecap and move my fingers back and forth on the inner side of my knee, I can hear and feel clicking/popping and it is quite uncomfortable.

I saw a doctor (different to the one I saw originally) and she ordered an MRI. I received my results today and apparently have patellar maltracking. I have an appointment with a knee surgeon on the 22nd of May to discuss treatment. The MRI report read as follows:

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MRI OF THE RIGHT KNEE

Diagnosis:
Small amount of marrow oedema within the superolateral aspect of Hoffa's fat pad which can be due to symptomatic impingement (see discussion).

Discussion:
I note the patient has symptoms related to the inferior patella. Lateral to the midline in the superior margin of Hoffa's fat pad, there is a small amount of soft tissue oedema. Oedema in this location can be due to impingement of the fat pad and it does have an association with the patellar maltracking although there were no other findings to suggest patellar maltracking such as a shallow trochlear groove. The patella was normally located on the fully extended knee although this is of limited diagnostic value with regard to maltracking of the patella. There were no obvious cartilage defects seen within the patella or the trochlear surface of the femur. No evidence of meniscal tear was seen. The anterior and posterior cruciate ligaments as well as the medial and lateral collateral ligaments were intact. No significant knee joint effusion was seen. No bone marrow pathology was seen.

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My doctor noted that physiotherapy may be my only option in regards to treatment but I am concerned with how effective this would be when it did not significantly help the first time. I have put up with this pain for a year and a half and frankly just want it fixed so I can return to regular activities. Has anybody had surgery to treat patellar maltracking and would you recommend it? Can anybody see any other problems that could be present that have been overlooked?

Thanks in advance