Many patients with signs and symptoms of patellofemoral arthritis do not respond well to conservative treatment modalities. Patients with isolated patellofemoral arthritis with severe anterior knee pain may be candidates for patellofemoral arthroplasty. The success of the procedure and the long-term survivorship of the implant rely on good surgical technique and adherence to strict indications and contraindications in patient selection. Newer implant designs have also contributed to improved outcomes.