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Objective To explore diagnostic method and surgical outcome of lateral patellofemoral crush syndrome caused by military training. Methods Fifteen patients with lateral patellofemoral crush syndrome caused by military training from May 2006 to May 2008 were enrolled in this study, including 12 men (14 knees) and 3 women (3 knees), aged from 22 to 43 years old with an average of 27.3 years. Randomly selected 18 healthy volunteers with similar age and gender but no knee pain symptom were selected to serve as a control group. Anteroposterior and lateral X-ray photographs of knee joint and axial photographs of the patella were taken in both groups for observing the bone architecture of the knee joint and measuring the femoral trochlear angle, patellofemoral congruence angle and patellofemoral index, and the data were compared. The 17 knee joints in patient group were treated with lateral patellar retinaculum release. Then the preoperative and postoperative pain severity was evaluated with visual analogue scale (VAS). Results Patellofemoral congruence angle was 7.67°± 5.81° and patellofemoral index was 2.49±1.40 in patient group, while they were －2.2°±－2.71° and 1.25±0.15 in control group. The difference between two groups showed statistical significance (P < 0.05). The change in bone architecture was obvious in patient group. The preoperative pain score was 7.06±0.85, and postoperative pain score was 3.87±0.24 after 6 months and 3.01+0.17 after 1 year in patient group. The difference between preoperative pain score and postoperative pain score showed statistical significance (P < 0.05). Conclusions Diagnosis of patellofemoral crush syndrome caused by military training requires a combination of case history, typical symptoms, objective sign and X-ray examination. Among these, X-ray examination is the fundamental auxiliary diagnostic tool for lateral patellofemoral crush syndrome, and the patellofemoral index is convenient for diagnosis.