Objective To investigate the clinical efficacy of arthroscopic patelloplasty combined with lateral retinaculum release in patients with patellofemoral arthritis and the correlation between imaging and gait.Methods From December 2020 to January 2022，a total of 75 patients with patellofemoral arthritis diagnosed in the Department of Orthopedics in Gansu Provincial Hospital of Traditional Chinese Medicine were selected.32 males and 43 females were included.The average age was (56.10±8.17) years old，ranging from 42 to 67 years old.The average course of disease was (4.20±2.44) years.There were 42 cases of left knee and 33 cases of right knee.anteroposterior and lateral X-ray，30 °patellar axial X-ray and knee CT examations were performed before surgery，6 months and 12 months after surgery.Gait tests were performed before surgery and 12 weeks after surgery.The corresponding Insall index，peel index，lateral patellar angle，patellofemoral fit angle，patellar tilt angle and other imaging indicators，as well as gait parameters such as foot distance，gait frequency，gait speed，support time and weight distribution were measured.Pearson correlation analysis was performed between imaging parameters and gait parameters.Results By comparing the imaging indexes and gait parameters before and after treatment，the Insall index，peel index，patellofemoral fitness angle index，lateral patellar angle index and patellar tilt angle index after treatment were significantly improved compared with those before treatment，and the difference was statistically significant (P＜0.05).After treatment，the gait parameters of patients' feet，such as stride distance，gait frequency，support time，weight distribution，were compared.before and after treatment.The gait of patients improved significantly after operation，and the difference was statistically significant (P＜0.05).Pearson correlation analysis showed that there was a certain correlation between the improvement of imaging indicators and gait parameters.The lateral patellar angle was positively correlated with gait，and the correlation coefficient (r value) ranged from 0.512 to 0.682，which was the highest correlation with gait speed.The Insall index，peel index，patellofemoral fit angle and patellar tilt angle were negatively correlated，and the correlation coefficient (r value) ranged from －0.831 to －0.143，which had the highest correlation with weight distribution.Conclusion Arthroscopic patelloplasty combined with lateral retinaculum release can improve the imaging and gait changes of patients with patellofemoral arthritis，and there is a certain correlation between imaging indicators and gait.