Background: The treatment of patellofemoral arthritis places high demands on orthopedists. The exact analysis of the underlying pathobiomechanical relationships is the basis for every therapy decision.
Methods: Soft tissue procedures, such as medial patellofemoral ligament (MPFL) reconstruction for stabilization and bone interventions for alignment optimization (e.g. tuberosity transfer and corrective osteotomy) can play a role in treatment. In cases of advanced patellofemoral arthrosis these interventions can be used as well as in combination with partial joint replacement. For the choice of implant the use of anatomical prosthesis types is recommended because with these components the number of additional procedures can be reduced.
Conclusion: The success of patellofemoral prosthetics depends mainly on the recognition of biomechanical deviations. If these can be corrected the risk of implant failure can be reduced.