Patellofemoral arthrosis: the treatment options

Patellofemoral arthritis is a relatively common and frequently complex problem encountered by those who treat patients with anterior knee pain. Because the pathologic conditions that precipitate this pain are so varied, the treatment options must also be varied. Using the Insall classification system for chondral injuries, we explored the treatment options available. Special emphasis was placed on grade IV changes and the surgical treatment of this condition. We reviewed the following options: spongialization, tibial tubercle elevation, patellectomy, patellar resurfacing, patellofemoral arthroplasty, and autologous chondrocyte transplantation. Regardless of the procedure favored, proper patellar tracking must be restored. Without such attention to patellar alignment, patients cannot achieve pain-free function.