Question
A 41 year old woman with longstanding patellar maltracking has severe anterior knee pain. Her tibiofemoral compartments are normal on arthroscopy.
- What procedure has been performed?
- What are the indications and contraindications?
- What are the outcomes and modes of failure?
Answer
Procedure
- Patellofemoral arthroplasty with a trochlear component and resurfaced patella
Indications
- Isolated patellofemoral osteoarthritis
- Trochlear dysplasia with secondary arthritis
- Post-traumatic patellofemoral arthritis
- Failed non-operative care
Contraindications
- Tibiofemoral arthritis or meniscectomy
- Inflammatory arthritis or chondrocalcinosis
- Uncorrected maltracking or malalignment
- Fixed flexion deformity
- High BMI is a relative contraindication
Outcomes
- Second generation onlay designs have better results than inlay designs
- Faster recovery and better kinematics than TKA
- Revision about 10 to 20% at 10 years, higher than TKA
- Progression of tibiofemoral arthritis is the main failure mode
- Patellar maltracking and catching
- Convert to TKA with good results
Related pages
Author Contributions
Orthofracs team
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.