The frequency of exercise-related injuries for physical activities and sports that have specifically lead to surgical intervention are rarely reported, especially regarding the patellofemoral articulation. Medical records from 1992 to 2005 of a multisite, urban-based hospital serving both large urban and rural populations were analyzed retrospectively. Injury data were presented by age, gender, and sport of choice. Significant (χ² = (6,519) = 31.097, p < .001) differences were found between age categories (adolescent, teenage, and adult) for the injuries leading to surgery. Significant gender (χ² (3,519) = 18.064, p < .001) differences were also found. This study presented a 13-year retrospective analysis of injuries to the patellofemoral joint leading to surgical endpoint, and found age and gender to significantly influence the frequency of injuries. Studies suggest that gender differences have not declined in response to the increasing number and experience of female athletes.