Patello-Femoral (Kneecap) Replacement

This surgery aims to relieve pain caused by damaged surface of your kneecap grinding against your thighbone. The main cause for damage is osteoarthritis, where the cartilage wears out causing your bones to rub against one another when you walk, squat or climb stairs. Patello-femoral Knee Replacement surgery replaces a portion of your knee joint, under your knee cap and the adjacent part of the thighbone, with a new artificial joint.

Do you need surgery?

Patello-femoral Replacement is a good option if you have severe pain resulting from damage in your knee joint that is limited to the underside of the kneecap. If you also have ligament damage, poor patellar tracking, inflam-matory arthritis or crystalline arthritis, you may require a different treatment. Your surgeon can help you decide when and whether surgery is right for you.

What happens during surgery?

A surgical incision is made at the front of the knee. All three compartments of the knee joint are explored to confirm damage is limited to the patello-femoral joint. The damaged kneecap and adjacent part of the thigh bone are re-moved. A plastic button is fixed to the underside of your kneecap, and a new metal surface is fixed to the front of the thigh. The skin incision is usually closed with staples.

What could go wrong?

With this surgery complications are rare, but include infection, blood clots, delayed healing, pain, swelling and stiff-ness, and the risks of having an anaesthetic. Potential also exists that you may need more surgery if arthritis develops in the parts that have not been replaced, and you may need a Total Knee Replacement in the future. Over 70% of Patellofemoral Knee Replacements last 10 years or longer. Discussing risks and voicing any concerns is an impor-tant part of your consultations before having surgery.

Participating in your rehabilitation

Preparation for your recovery begins before your surgery. Being overweight increases stress on the knee and surgical risks. Aim to be a healthy body weight, keep active and strengthen your knee muscles in the lead up to surgery. Your stay in hospital may be 2-4 nights. Physiotherapy may begin the day of, or the day after surgery. Aims are to manage swelling, minimise pain, assist you to regain the arc of knee movement, get in and out of bed, walk using crutches, and to climb stairs. Some knee pain and stiffness are expected, especially during the initial weeks. Be involved and positive during therapy, and diligently perform your exercises at home.

Benefits you can expect

100% of patients who walked without an aid prior to surgery can do so again in less than 3 months. This is relatively new surgery and whilst the long-term results are not yet known, they appear promising. In general, patients expe-rience a shorter recovery, less blood loss, less pain, better physical function, and a greater range of motion than Total Knee Replacement patients. We expect most patients will achieve significant pain reduction and full recovery by 12 months.