Patellofemoral Arthroplasty

Patellofemoral arthroplasty (PFA) as a treatment option for isolated patellofemoral disease continues to evolve. Enhancement in patient selection, surgical technique, implant design, and technology has led to improved short-term and midterm outcomes. Furthermore, in the setting of a younger patient with isolated patellofemoral arthritis, PFA represents an option for improved function with faster recovery times, bone preservation, maintenance of ligamentous proprioception, and the ability to delay total knee arthroplasty (TKA). The most common reason for revising PFA to a TKA is progression of tibiofemoral arthritis. In general, conversion of PFA to TKA leads to successful outcomes with minimal bone loss and the ability to use primary TKA implants and instrumentation. PFA seems to be a cost-effective alternative to TKA in appropriately selected patients with 5-, 10-PFA survivorships of 91.7% and 83.3%, respectively, and an annual revision rate of 2.18%; however, more long-term clinical studies are needed to determine how new designs and technologies affect patient outcomes and implant performance.