I had no knee pain until this summer when I got a road bike. Then I needed to pay closer attention to saddle position and riding style.

Twinges on the front inside of the knee indicated the saddle was too far forward. Setting the saddle back a bit minimized that problem. Meanwhile I wore a Mueller jumper's knee strap to help with patella tracking -- it's just a dense foam tube inside a narrow band. Helped a lot.

Unfortunately that led to more pressure and chafing on the perineum. So tilted the saddle nose down one notch. That relieved the perineum discomfort.

Unfortunately that led to slipping downward a bit toward the nose of the saddle, and the knee twinges again. So I concentrated on using my legs more to stay back on the saddle. That helped, but is also more tiring.

Feels like I'm chasing my own tail. I may need a new saddle, something to keep me in the sweet spot without perineum pressure or relying on leg effort just to stay in the sweet spot. I'd rather reserve my quads for pedaling.