Patellofemoral arthroplasty with a customized trochlear prosthesis.

Successful patellofemoral arthroplasty depends on appropriate patient selection, proper prosthesis design, and correct surgical technique. Clinical results using off-the-shelf patellofemoral prostheses have reported mixed results primarily because of an inability to address these important characteristics adequately. This article reviews the design rationale, excellent clinical history, and straightforward surgical technique of a unique approach to patellofemoral arthroplasty that incorporates a customized trochlear prosthesis designed to fit the individual patient's patellofemoral groove. Clinical results using this customized approach demonstrate that it is a safe and effective treatment option for patients who have isolated patellofemoral arthritis.