Patellofemoral Pain and Arthritis in Latter Middle-Aged Patient, with Marginal Osteophytes and General Patellofemoral Chondrosis

The management of patients affected by isolated patellofemoral osteoarthritis and associated anterior knee pain represents a challenging diagnosis for the orthopedic surgeons. Newer generation patellofemoral replacement implants have emerged as an excellent option for patients presenting with isolated patellofemoral osteoarthritis (PFOA). However, controversy remains about the management of isolated PFOA, and better understanding of the most suitable patient for patellofemoral replacement treatment is mandatory to better address the anterior knee pain and the functional impairment due to PFOA. In this chapter, the two senior authors (SZ and EA) review a case of isolated PFOA in a latter middle-aged patient. The case is a 58-year-old female who presented with chronic left knee anterior knee pain exasperated by bent knee activities such as climbing stairs and squatting, with isolated PFOA at imaging examination. After a trial of non-operative management, the patient underwent a patellofemoral arthroplasty. At 1 year follow-up she was doing well without any symptoms on her left knee. A concise overview of the current concepts of treatment of PFOA, with patient selection for patellofemoral arthroplasty and its outcomes is provided.