The evolution of patellofemoral prosthetic design in total knee arthroplasty: how far have we come?

Total knee arthroplasty (TKA) has evolved into a successful, cost-effective treatment for end-stage knee arthrosis.

The patellofemoral articulation in TKA has largely been ignored during its development despite being an important determinant of outcome.

New technologies still need further development to incorporate the patella in TKA surgical planning and operative technique.

Alternative approaches to alignment in TKA will have a secondary impact on patellofemoral mechanics and possibly future implant designs.

Technologies that assist with precise implant positioning may alter our understanding and overall practice of TKA.