Isolated Patellofemoral Replacement

Isolated patellofemoral arthritis — arthritis limited to the kneecap and the groove it glides in — can cause significant pain when climbing stairs, rising from a chair, or walking on inclines. Patellofemoral replacement, also called patellofemoral arthroplasty, is a surgical option that resurfaces only this portion of the knee while preserving the healthy parts.

What is an Isolated Patellofemoral Replacement?

During an isolated patellofemoral replacement, a surgeon removes damaged cartilage from the underside of the kneecap and the trochlear groove of the femur. These surfaces are then replaced with a smooth, durable implant made of metal and high‑grade plastics.

Unlike a total knee replacement, this procedure preserves the rest of the knee — including the tibiofemoral joint and all major ligaments — allowing many patients to maintain a more natural knee motion.

Who Should Have a Patellofemoral Replacement?

This surgery is best for patients whose arthritis is truly isolated to the patellofemoral compartment. Ideal candidates typically:

• Have pain primarily in the front of the knee
• Experience difficulty with stairs, squatting, or rising from a seated position
• Have tried nonsurgical treatments such as physical therapy, medications, or injections
• Have good alignment and intact ligaments
• Do not have significant arthritis in the other compartments of the knee

If your pain persists during daily activities and conservative treatments no longer provide relief, your surgeon may discuss whether patellofemoral replacement or partial knee replacement is the better option.

How Well Does Patellofemoral Replacement Work?

For the right patient, patellofemoral replacement can be highly effective. Many people experience:

• Relief from kneecap‑related pain
• A smaller incision and less tissue disruption
• Faster recovery than a total knee replacement
• A knee that feels more natural because most of the joint is preserved

At OrthoNebraska, our high surgical volume, low infection rates, shorter hospital stays, and strong nurse‑to‑patient ratios contribute to excellent outcomes. Our team specializes in helping patients return to the activities they enjoy.

Overall success and satisfaction

Modern patellofemoral replacement shows good or excellent outcomes in more than 80% of appropriately selected patients, with most studies reporting high satisfaction and meaningful pain relief.

A 2022 independent‑center study found good or excellent functional outcomes in more than 80% of patients, with 62% very satisfied and 26.7% satisfied at mid‑term follow‑up.

Modern implants have a survivorship of about 90% at five years, and many last 10–15 years or longer. As with any partial knee procedure, long‑term success depends on choosing the right patients — those whose arthritis is truly limited to the kneecap area. The most common reason for revision is progression of arthritis in other parts of the knee.

What Can I Expect when I have a Patellofemoral Replacement?

Before surgery

We will encourage you to:

• Arrange for help at home for the first few days
• Prepare your home by clearing walkways, removing loose rugs, and securing handrails
• Complete a pre‑surgical physical with your primary care provider and any needed specialists

On the day of surgery, you will meet with your surgeon and anesthesiology team. Depending on your needs, anesthesia may include a nerve block, spinal anesthesia, or general anesthesia. The procedure typically takes about 1 hour, followed by 1–2 hours in recovery before moving to your private room.

After surgery

Outpatient physical therapy is common prescribed and helps restore strength, mobility, and proper kneecap tracking in the weeks after your surgery until you are healthy enough to continue recovery without weekly guidance.

Recovery timeline

Recovery is similar to partial knee replacement, with many patients:

• Walking with assistance the same day
• Returning to daily activities within a few weeks
• Continuing to improve over several months

Full recovery varies depending on overall health, knee alignment, and dedication to therapy or home exercises as directed by your surgeon.