Partial lateral patellar facetectomy in primary total knee arthroplasty: a common addition with limited support

Partial lateral patellar facetectomy (PLPF) is a surgical procedure that consists in removing a part of the lateral facet of the patella. It has been first described as a surgical treatment for isolated external patellofemoral osteoarthritis. Following the same biomechanical effects, some authors proposed to perform PLPF in primary total knee arthroplasty to enhance patellar tracking and reduce the risk of anterior knee pain, whether the patella resurfaced or not. According to few studies of low level of evidence, functional scores are not improved when performing systematic PLPF. Current data are controversial regarding the role of systematic PLPF in enhancing patellar tracking. No evidence exists that PLPF protects un-resurfaced patella from revision for PF issues after TKA. In light of the available literature, PLPF cannot be recommended systematically in primary or revision TKA. However, precise relevant indications can be proposed.