Patellofemoral Arthroplasty
What is patellofemoral osteoarthritis?
The knee joint is formed by the fusion of the distal femur (thigh bone), proximal tibia (shin bone), and patella (kneecap), and can be divided into three sections: medial (towards the midline), lateral (away from the midline), and patellofemoral. The patellofemoral section encompasses the front of the knee, including the patella and femur. The patella sits in the trochlear groove, a bony canal on the distal femur; it moves along this groove during knee flexion and extension.
The bones of the knee joint, including the underside of the patella, are covered with articular cartilage. This cartilage reduces friction and allows the bones to slide together painlessly. Osteoarthritis occurs when this cartilage deteriorates or is damaged, causing the bones to rub against each other. This condition can affect all parts of the knee, or it may be limited to a single area; this is called unicompartmental osteoarthritis.
What is the treatment for patellar-femur joint inflammation?
Patients experiencing mild to moderate pain in the anterior knee due to patellofemoral osteoarthritis can often benefit from conservative treatments. Rest, alternating ice and heat applications, and NSAIDs (non-steroidal anti-inflammatory drugs) can control pain and inflammation. If pain persists, corticosteroid injections can be applied directly to the patellofemoral region. A physical rehabilitation program is also recommended when appropriate.
If chronic and severe anterior knee pain affects daily life or if conservative treatment is ineffective, surgery may be necessary. Traditionally, total knee replacement, which replaces all sections of the knee, was performed. However, technological advances have made partial knee replacement possible for patients with only one affected area. Patellofemoral arthroplasty is a less invasive procedure that reconstructs the inferior surface of the patella and the trochlear groove with metal and plastic implants.
Serkan Sürücü treats patients with patellofemoral osteoarthritis who require patellofemoral arthroplasty.
Advantages of Patellofemoral Arthroplasty
Whether patellofemoral arthroplasty is suitable is evaluated considering the patient’s age, medical history, and expectations. This procedure allows for faster recovery due to smaller incisions and less surgical trauma. Thanks to greater preservation of natural tissue, patients experience a more natural feel and better knee function compared to total knee replacement.
How is patellofemoral arthroplasty performed?
As a less invasive alternative to total knee replacement, patellofemoral arthroplasty (partial knee replacement) typically requires only a one-night hospital stay. Before the procedure, a nerve block is administered for pain management, and the patient is positioned appropriately.
Dr. Serkan Sürücü performs a final examination of all knee compartments under anesthesia to verify ligament integrity. An incision is then made at the front of the knee to expose the patellofemoral region. The entire joint is systematically inspected to confirm that the damage is limited to only one side (the patellofemoral compartment). The procedure is completed in two stages:
- Bone Preparation: Damaged tissues on the undersurface of the patella and within the trochlear groove are removed using specialized surgical instruments. Small bone adjustments are made to accommodate the prosthetic implants.
- Implant Placement: The trochlear groove is resurfaced with a metal component, and the undersurface of the patella is fitted with a high-density polyethylene “button.” Both implants are secured using bone cement.
Purpose of the Procedure and Indications
Patellofemoral Arthroplasty is not planned simply to correct a scan finding. Candidacy brings together pain, loss of function, the structural problem, the quality and duration of appropriate non-surgical care, and the patient's work or sporting goals. The expected benefit and limitations are defined before surgery so that the operation addresses a clinically meaningful problem.
Who Is a Candidate and When Is Surgery Deferred?
The diagnosis should be supported by examination and imaging, and expected benefit should outweigh risk. Active infection, uncontrolled medical disease, smoking that materially affects healing or an inability to participate in rehabilitation may need attention first. Age alone does not decide treatment; tissue quality, activity goals and overall health are considered together.
Preparing for Surgery
Medicines, blood thinners, allergies and previous operations are reviewed, and medication is not stopped without medical advice. Transport, help at home and early daily tasks are planned in advance. The consent discussion covers the proposed procedure, possible additional work, pain control, protection and rehabilitation so that recovery expectations are practical.
How Is the Technique Chosen?
Open or arthroscopic access, implant or graft choice and associated procedures are matched to the anatomy of the problem. Operations with the same name do not contain identical steps for every patient. Findings at surgery may require the plan to be adjusted within the alternatives discussed beforehand, particularly when tissue quality differs from imaging.
Anaesthesia and the First Days
Anaesthesia is selected for the extent of surgery and the patient's health; a regional block can support early pain control in some operations. Wound care, prescribed medicines, swelling control and sling or brace instructions matter during the first days. Permitted movement of the hand, foot or neighbouring joints helps maintain circulation and mobility without stressing the repair.
Risks, Alternatives and Review
Infection, bleeding, stiffness, nerve or vessel injury, persistent pain and failure to reach the intended result are general risks; procedure-specific risks are discussed separately. Alternatives may include activity changes, physiotherapy, medication or injections depending on the diagnosis. Increasing wound redness or drainage, fever, new numbness or weakness, or unexpected severe pain needs prompt review. The next step should reflect the diagnosis, the demands placed on the joint and the patient's goals. You can review knee care, read about knee arthroscopy, or request an assessment for an individual plan.
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