Optimizing patellofemoral arthroplasty.

Patellofemoral arthroplasty (PFA) has been an option for patients with symptomatic patellofemoral osteoarthritis since the 1950's. Many of the early failures resulted from a combination of implant design and surgeon technique. The goal of this overview is not to review the history of PFA, but rather to explore options for surgeons to optimize long-term outcomes and improve patient knee function, while highlighting the differing techniques required in PFA with those routinely adopted in total knee arthroplasty (TKA).