Knee pain

[ginger]

Fitz, I don't have a lot of time to spend on a decent response to your query , but I feel compelled to offer a few brief insights that you may not enjoy, When being treated for any condition by a person with significant training ,, one can expect the treatment to reflect the style, training , skill and persepective of the doctor/physio/ therapist etc. In other words , you get the ideas and methods asociated with different streams of thought and action , rather than a conglomerate of all.
That being so , it is certain that the thread of attention true for surgeons is to treat with surgury, for massage therapists with massage, for physiotherapists with an appreciation of function or lack therof.
You have had a knee pain problem that is not uncommon ,( sometimes called PFS ) that is the result of two related neural mechanisms. Fistly , the Irritation present with a tight L3 facet joint, in your lower back has driven a sensory/neural pattern of behaviour. The pattern relates to inflammatory changes present at that facet joint and the nerve root adjacent , becoming part of the femoral nerve. This nerve , amongst other things , serves the muscles adjacent to your knee cap, known as Vastus medialis oblique (VMO ). Inhibitory effects of nerve root irritation has prevented full and normal recruitment of VMO, such that a tendency to drift lateraly occurred. This caused inflammation , pain swelling and further inhibition.
Your surgery was an attempt at solving this problem , by altering the angles associated with the pull of VMO over your pattella. While it is fair to assume there will be value in this to some degree, it is a bit like trying to get your computer to stop crashing ( insert appropriate analogy here, ie subtle effect of software) by rebuilding the key board in a better shape. In other words , the cause has not been addressed, only the symptom. Apparently, with little or no real understanding of that cause.
Your knee pain as mentioned, still bothering you, at the tubercle is no less and no more the same referred event that drove the patella to misbehave. If no one has dealt with your lower back , in particular at L3 and L4 , by dilligent manual movement therapy aimed at restoring normal movement and thereby removing the irritation at the femoral nerve root, then you will like as not continue to complain of the ORIGINAL problem, although modified by having surgery.
All too often I am witness to the inappropriate use of surgery to correct what could have been eliminated by a skilled pair of hands with the right understanding . I wish you well nevertheless.
I do recommend however that you find a good Physiotherapist, preferably Australian trained, to mobilise your lumbar spine thoroughly. Your complaint will almost certainly dissappear, provided that physio has good hands on skill , does not use modalities, offer you exercise as way to treat yourself or use ancient and useless methods like traction.
best of luck.