Knee alignment problems and cycling are a VERY big deal- I rode my way into bilateral reconstructive surguries last year, and I've got chondro patellae too. You need a good fit guy, who knows about things like Big Meat Power wedges and how and when to space out a pedal with a washer- there are all kinds of thigs to be done. Yoga class can help alignment issues too, the stretching pushes soft tissue back into place. I was riding pigeon toed and with my feet cocked up sideways- my mechanic said this is common and needs attention. If yours is so bad you're losing a Speedplay, it's time for action.
Go to <www.bicyclefit.com> and fish around, and write or call the guys about a good fitter in your area. They're super nice, true bike folk, and can send you to sombody first rate or tell you what to do. They really helped me when my knees were so bad I couldn't walk. You don't want to wear on that kneecap any more- one of mine is a grade 5 and it just hurts like the devil some days. It'll also mess with your hip, and you may have foot issues and be happier with orthotics. Then there's the SI joint problems knee misalignment can cause.
If you ever need to suck it up and have a lateral release surgury, they have new equipment and it's not so bad. My first leg was awful, but the second knee, I walked out of the hospital with my crutches over my shoulder.
I don't know where you are, but there are excellent proffessionals who can fix you up. Be leery of the mediocre, they will waste your time. Ask around.
Finally, theres nothing wrong in putting clips on the bike. Clipless are neat, but there's a lot of fashion pressure to use them. It isn't worth worsening arthritis.
Put the bike in front of a mirror on a trainer, put a stiky dot or small post it on the center of each patella, pedal. If the knees are corkscrewing, or doing a figure eight, see somebody medical.
Been there, done that.

missliz