Joint-Preserving Osteotomies for Isolated Patellofemoral Osteoarthritis: Alternatives to Arthroplasty.

Patellofemoral osteotomies can provide excellent symptomatic relief for selected patients with isolated patellofemoral osteoarthritis (PFOA). Isolated PFOA is a relatively common disorder, seen in 24% of women and 11% of men over the age of 55 years. In up to 89% of these patients, PFOA occurs at the lateral facet of the patella, and is especially amenable to surgical treatment. Particularly in younger patients, joint-preserving osteotomies can provide excellent and reliable relief while delaying the need for partial or joint arthroplasty and subsequent revision. These osteotomies, such as partial lateral patellar facetectomy (PLPF), patella-thinning osteotomy (PTO), tibial tubercle anteromedialization (AMZ) osteotomy, and sulcus-deepening trochleoplasty (SDT), are reviewed for indications, technique, and results. In particular, patients with primarily lateral facet or distal and lateral lesions have excellent outcomes with patellofemoral osteotomies.