My kneecaps are unstable and i have cartilage damage under my kneecaps. i had surgery only for the kneecap alignment, no improvement. any suggestions?

Did U get therapy at: All? Was surgery by scope or was it open? If the first time a realignment surgery does not work, i recomend doing it again openly, by extensive release laterally of the knee cap (kc). If it still does not work then you'll probably need transferring the kc's attachment into the upper leg bone. These surgeries will most likely help, but the therapy is the most important component of the treatment.

Instability Complex: Patellar instability is a multi-factorial problem. It is important to evaluate each factor and then address them in a systematic manner. The common factor is a tear of the medial patellofemoral ligament (mpfl) and most treatments include reconstruction of the mpfl for recurrent dislocations. Other factors include: a high riding patella, a mis-shaped trochlea, excessive lateral tuberosity position.