[The third compartment in knee endoprosthetics: from denervation to replacement, which therapy is correct?]

Involvement of the patellofemoral compartment is common in osteoarthritis of the knee but to date there is no consensus as to the most appropriate approach concerning the patella. Both general non-selective resurfacing as well as selective or secondary resurfacing are currently accepted. However, despite abundant studies on the subject no clear conclusions can be drawn from the available evidence. There are arguments in favour of either approach. Accordingly, no strong evidence can be found to support peripatellar denervation. With the advent of new diagnostic modalities for the assessment of knee osteoarthritis, such as single photon emission computed tomography/CT (SPECT/CT), a more selective approach to patellar resurfacing with a potentially improved outcome might become possible.