Introduction: Indications for patellofemoral arthroplasty (PFA) remain under debate, with many surgeons favoring total knee arthroplasty (TKA) even in patients with limited degeneration in the tibiofemoral compartments.
Case report: A 30-year-old man with a history of bilateral patellar instability treated in youth with multiple surgeries presented with 8+ months of recurrent bilateral knee pain. Evaluation showed bilateral severe patellofemoral arthritis with preserved medial and lateral compartments. Bilateral sequential robotic-assisted PFAs (RA-PFA) were offered as a precise approach to reconstructing patellofemoral biomechanics while minimizing bone resection to avoid compromising potential future TKA. Four months after his latest surgery, he returned to a physically demanding job, and he remains active and pain free at 1 year postoperatively.
Conclusion: RA-PFA can provide less invasive, accurate, and individualized treatment for younger patients with severe disease without compromising future conversion to TKA.
Keywords: Robotic; patellar instability; patellofemoral arthroplasty; patellofemoral osteoarthritis; trochlear dysplasia.
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