Patellofemoral arthritis and its management with isolated patellofemoral replacement: a personal experience.

Trochlear dysplasia is a common precursor of patellofemoral arthritis and may account, in part, for persistent anterior knee pain. After pathologic changes have been demonstrated by radiography, magnetic resonance imaging, or arthroscopy, isolated patellofemoral replacement usually can help, but a modern prosthesis and accurate instrumentation must be used. In addition, patient selection must be precise to achieve successful treatment outcomes. This means ensuring that the arthritic process is confined to the patellofemoral joint, and the patient has a stable mental state. Middle-aged patients with arthritis and instability secondary to trochlear dysplasia are probably the most appropriate group for this procedure.