Patellofemoral joint replacement surgery targets anterior knee pain with a precise, minimally invasive solution.
A partial knee replacement with a patellofemoral prosthesis
A patellofemoral prosthesis (PFP) is a partial knee implant designed to treat isolated cartilage damage in the joint between the patella and the femur.
Professor Étienne Cavaignac, an orthopaedic knee surgeon based in Toulouse, is performing this procedure at high volume with robotic assistance.
Unlike total knee replacements, patellofemoral joint replacement preserves healthy compartments, offering a more conservative and precise solution when the rest of the knee is unaffected.
What is a patellofemoral arthroplasty?
Also known as patellofemoral joint arthroplasty, this procedure is ideal for patients with localised patellofemoral arthritis, often resulting from instability, trauma or trochlear dysplasia.
What is the difference between PFP and total knee replacement?
A PFP targets only the joint between the kneecap and femur, preserving the rest of the knee, while a total knee replacement involves all compartments.
When and why a patellofemoral joint replacement surgery may be right for you
Before getting a patellofemoral joint replacement surgery, there are a lot of factors to consider.
Clinical Indications and Ideal Candidates
Indications for patellofemoral joint replacement include:
- Patellofemoral osteoarthritis due to dysplasia, instability or trauma
To be eligible for a patellofemoral joint replacement procedure, patients must meet strict criteria. Professor Cavaignac personally evaluates each case using a combination of clinical examination and imaging to ensure that:
- The tibiofemoral compartments are intact
- Ligaments are stable
- Knee mobility exceeds 120°, with no significant flexion contracture (< 10°)
The ideal candidate is under 65 and active. However, Professor Cavaignac stresses that individual anatomy and symptoms matter more than age alone.
Is a patellofemoral prosthesis suitable for older patients?
While younger patients are often ideal, age is not the only factor. If the damage is localised and joint mechanics are preserved, older patients may still benefit.
From patellofemoral implant design to surgical precision
Thanks to advances in materials and design, patellofemoral implants now offer improved durability, anatomical fit and optimal tracking of the patella.
There are two main generations of PFP implants:
- First-generation (resurfacing implants): e.g., Richards™, Lubinus™, Autocentric™
These mimic native trochlear anatomy but are less forgiving to malalignment and have higher revision rates.
- Second-generation (anterior femoral cut implants): e.g., Avon™, Journey™, Hermes™
These offer better alignment, improved surgical technique compatibility, and lower mechanical complication rates.
Professor Cavaignac uses the latest-generation implants to ensure stable results and long-term success. His surgical technique also limits bone resection, making future revision, if necessary, simpler and safer.
Professor Cavaignac routinely uses the onlay patellofemoral prosthesis, a modern implant design that ensures anatomical fit, stable patellar tracking and simplified conversion to total knee replacement if needed in the future.
To better understand the surgical process, you can watch this patellofemoral joint replacement video featuring Professor Cavaignac performing the procedure.
Can patellofemoral arthroplasty be performed using robotic assistance?
Yes, robotic guidance for patellofemoral arthroplasty offers enhanced precision and contributes to better alignment, stability, and patient satisfaction.
Results you can expect: outcomes and patellofemoral arthroplasty recovery
Patellofemoral arthroplasty recovery offers encouraging outcomes for patients carefully selected by Professor Cavaignac, with noticeable improvements often occurring in the first days and weeks after surgery. However, successful recovery doesn’t just depend on the operation itself: rehabilitation is a key pillar of the process.
Postoperative Benefits and Functional Gains
Under the care of Professor Cavaignac, patients typically notice:
- Marked reduction in anterior knee pain : 77%
- Improved stair-climbing ability : 65%
- Improved walking : 74%
Patellofemoral joint replacement recovery is generally faster than for total knee replacement, especially when minimally invasive and robotic techniques are used. The right care for a PF prosthesis begins from the earliest days post-surgery as patients start working with a physiotherapist to restore motion and function.
Rehabilitation starts with gentle range-of-motion exercises and progressive weight-bearing. Professor Cavaignac’s team follows a structured protocol adapted to each case, focusing first on pain control, regaining extension and reducing swelling. This is followed by muscle strengthening (particularly of the quadriceps and glutes), walking re-education and balance training.
Throughout this period, digital tools such as Orthense enable close remote monitoring and adjustment of your programme, ensuring steady progress and optimal outcomes.
Most patients can resume light daily activities within a few weeks. However, while low-impact activities like walking, swimming or cycling are encouraged, extreme flexion (e.g. kneeling) may remain limited.
How long is the recovery time after PFP surgery?
Patients typically walk within days. Return to low-impact activities takes a few weeks, while full recovery may require 3 to 6 months.
To discover more about his approach, see his interview with Medical Tourism Magazine, where he discusses innovation, precision, and international care pathways.
Can I return to sports after a patellofemoral joint replacement?
Low-impact sports are generally safe. High-impact activities should be avoided or carefully reintroduced with medical guidance.
Known Risks and Long-Term Considerations
Professor Cavaignac ensures each patient understands the potential long-term considerations:
- Revision rates: 14–25% at 10 years, mainly due to femorotibial arthritis progression
- Technical pitfalls: overstuffing, malpositioning, patellar maltracking
- Early complications: anterior knee pain, stiffness, infection
- Late complications: wear, loosening, implant rupture, tibiofemoral osteoarthritis
Thanks to his use of second-generation implants and precise placement, the risk of revision is significantly reduced.
What happens if the prosthesis wears out?
In most cases, it can be converted to a total knee replacement without difficulty, especially with newer-generation designs.
A personalised approach by Professor Cavaignac
Choosing the right surgeon is critical for the success of a patellofemoral joint replacement protocol. Professor Étienne Cavaignac stands out through:
- His exclusive focus on knee replacement surgery
- Over 500 ACL and patellofemoral procedures annually
- Robotic-assisted expertise with reproducible results
- A commitment to personalised care, from surgical planning to recovery
Prof. Cavaignac offers high-level care to both French and international patients. Professor Cavaignac is internationally recognised for his contributions to modern knee surgery.
Ready to Explore Your Options?
If you suffer from persistent anterior knee pain and wish to avoid total knee replacement, patellofemoral joint replacement may be your solution. With his unparalleled expertise and cutting-edge technology, Professor Étienne Cavaignac ensures you receive the highest standard of care.
Schedule an appointment to discuss your treatment plan and recovery options.