Patellofemoral Replacement in Birmingham
Patellofemoral replacement resurfaces only the front compartment of the knee, the joint between the kneecap (patella) and the thigh bone (femur), when arthritis is isolated to this area. It is a bone-conserving alternative to total knee replacement for a carefully selected group of patients with anterior knee pain and patellofemoral arthritis.
Total procedures
Verified patient reviews
MAKO, ROSA and CORI robotic
The Front Compartment
What Is Patellofemoral Replacement?
Patellofemoral replacement is a partial knee replacement that addresses arthritis in the front compartment of the knee, the joint between the kneecap (patella) and the trochlear groove at the front of the femur. This area can develop isolated arthritis in patients who have had previous kneecap injuries, recurrent patellar dislocations, or trochlear dysplasia (abnormal groove shape).
Because the medial, lateral, and cruciate structures of the knee are preserved, patellofemoral replacement is a more conservative procedure than total knee replacement and typically gives a faster recovery and more natural knee feel for well-selected patients.
Who is suitable for patellofemoral replacement?
The key requirements are:
- Arthritis confirmed to be isolated to the patellofemoral compartment by X-ray and, ideally, MRI
- Normal or near-normal medial and lateral compartments
- Intact anterior cruciate ligament
- Anterior knee pain pattern (pain going up and down stairs, sitting, squatting)
- Failed non-surgical treatment including physiotherapy and injections
If arthritis is also present in the medial or lateral compartments, total knee replacement or a combined procedure may be more appropriate.
Symptoms of patellofemoral arthritis
Patellofemoral arthritis typically causes:
- Pain at the front of the knee, particularly on stairs and slopes
- Pain sitting for long periods (cinema sign or movie sign)
- Pain squatting or kneeling
- A grinding or crunching sensation at the front of the knee
- Occasional locking or giving way if the kneecap is catching
These symptoms overlap with other conditions, so imaging and clinical examination are needed to confirm the diagnosis before considering surgery.
Modern Implants
Second-Generation Patellofemoral Implants
Early patellofemoral replacement implants had high revision rates because of patellar maltracking and loosening. Second-generation designs, introduced in the late 1990s and continuously refined since, have a wider and more anatomical trochlear groove that accommodates natural patellar tracking much more reliably. Outcomes with modern implants are significantly better.
Mr Hussain uses current second-generation patellofemoral implants and assesses patellar tracking carefully at surgery to confirm the implant is functioning correctly before wound closure.
Improved NJR Outcomes
NJR data shows 10-year survival rates above 80 percent for modern patellofemoral implants in well-selected patients, comparable to medial unicompartmental replacement.
Bone Conservation
Patellofemoral replacement removes only the arthritic surfaces of the trochlea and patella, leaving all other bone stock intact. Conversion to total knee replacement, if ever needed, is straightforward.
Activity After Surgery
Because the load-bearing medial and lateral compartments are preserved, patients after patellofemoral replacement can often return to low-impact activities faster than after total knee replacement.
Recovery
Recovery After Patellofemoral Replacement
Recovery after patellofemoral replacement is similar to or faster than recovery after medial unicompartmental replacement. Key milestones:
- Day 1: walking with crutches, starting gentle knee bending exercises
- Week 1 to 2: wound healed, able to walk short distances at home
- Week 4 to 6: most patients progress off crutches, driving assessment
- Week 6 to 8: return to desk work and light activities
- 3 to 6 months: return to low-impact sports and most recreational activities
Physiotherapy is essential after patellofemoral replacement, with a focus on quadriceps strengthening and restoring normal patellar tracking through movement.
Specialist Arthroplasty Care
Patellofemoral Replacement with Mr Shakir Hussain
Patellofemoral replacement is a niche procedure that requires careful patient selection and surgical experience. Mr Hussain offers this procedure as part of a comprehensive knee arthroplasty service in Birmingham.
Your Questions Answered
Frequently Asked Questions
Ready to Discuss Your Knee Replacement?
Book a private consultation with Mr Hussain at the Royal Orthopaedic Hospital, Priory Hospital Edgbaston, or Harborne Hospital.