Abstract
Patellofemoral arthritis is a relatively rare and challenging disease. Patellofemoral arthroplasty (PFA) can be an effective treatment; however, its use remains somewhat controversial due to its high failure rates and variable results. There have been numerous studies published in the literature regarding first- and second-generation implant designs. The evolution of implant design, surgical technique, and patient selection has resulted in better midterm outcomes using second-generation designs. For the younger, more active population, PFA provides an alternative to total knee arthroplasty that allows patients to increase their activity level and decrease pain. PFA is a promising alternative to total knee arthroplasty for isolated patellofemoral arthritis. Although first-generation implants were associated with high failure rates at midterm follow-up, second-generation implants have yielded more positive and promising midterm results. Surgical indications and patient selection are crucial to minimize poor results. In addition, new technologies such as computer navigation and robotics have shown favorable good short-term results. Robotic-assisted second-generation designs are promising approaches to improve implant positioning and good midterm follow-up.
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