Birth defect, the cartilage you are born with that is suppose to go away when the kneecaps form didn't mine just hardened so my kneecaps did not fit in place and I could move them around. I ignored the pain and dealth with it till I was 29 then had 4 surgeries each a year apart removing bone in both legs, shaving kneecaps and relocating all the ligaments so now between the metal, arthritis and my fibromyalgia I have go days and bad days walking... And since I always stand odd with my hip out like I have an attitude people tend to think I am bitchy but nope just that leg is almost 2 inches shorter haha