Image-based robotic-assisted patellofemoral arthroplasty for isolated patellofemoral osteoarthritis: Short-term survivorship, clinical and radiographic outcomes.

Authors

Alberto Fogacci, Clément Favroul, Luca Andriollo, Pierre Longlune, Cécile Batailler, Elvire Servien, Sébastien Lustig

Published in

SICOT-J. Volume 12. Pages 66. Epub Oct 12, 2026.

Abstract

Patellofemoral arthroplasty (PFA) is a valuable option for selected patients with isolated patellofemoral osteoarthritis (PFOA), where component positioning and patellar tracking are critical determinants of outcome. Robotic assistance may improve these aspects, but available literature remains limited. This study evaluated early survivorship, complications, and reoperations after image-based robotic-assisted PFA (RA-PFA). Secondary aims were to assess clinical outcomes, return to sport, radiographic patellofemoral parameters, and agreement between planned and final implanted component position.
This retrospective single-center study included consecutive patients treated with RA-PFA for isolated PFOA between November 2021 and October 2024, with a minimum clinical and radiographic follow-up of 12 months. Primary outcomes were implant survivorship, reoperation-free survivorship, and postoperative complications. Secondary outcomes included Knee Society Score (KSS), range of motion (ROM), return to sport, radiographic patellofemoral parameters, and MAKO-derived plan-to-execution agreement. Kaplan-Meier analysis was used to assess survival.
Thirty patients (35 knees; 5 bilateral cases) were included, with a mean age of 61.3 ± 12.2 years and mean body mass index of 25.3 ± 5.2 kg/m². Most knees had advanced disease (Iwano grade III-IV, 91.4%). Mean follow-up was 15.7 ± 8.5 months. Overall reoperation rate was 8.6% (3/35), including two conversions to TKA. Survivorship free from revision was 96.7% (95% CI 90.2-100.0) at 12 months and 91.6% (95% CI 80.1-100.0) at 24 and 36 months. KSS improved significantly (from 110.7 ± 21.1 to 163.7 ± 22.3; p < 0.001). Median ROM remained 130°. Return to sport was achieved in 78.3% of active patients. Patellar lateralization improved significantly (4.7 ± 3.8 mm to 0.8 ± 1.8 mm; p < 0.001), with a reduction in patellar tilt. Plan-to-execution deviations were minimal, with 100% component size concordance.
Image-based RA-PFA was associated with encouraging early survivorship, substantial functional gains, preserved knee motion, and improved radiographic patellofemoral alignment at short-term follow-up. However, the specific contribution of robotic assistance cannot be determined in the absence of a conventional control group.
Level IV.

PMID:
42867179
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.

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