What exercise is best if you have miserable malalignment syndrome?

Avoid running--this will aggravate the syndrome. The best way to get cardiovascular exercise is to briskly walk. I find it much less painful to walk on dirt trails rather than concrete. I have also found that walking in hilly and uneven areas causes less knee and hip pain. It seems that varying terrain doesn't make my joints repeat the same motion continuously. Also the hills seem to engage my muscles more, thus taking some pressure off my joints. Swimming is good too.