Robotic patellofemoral joint replacement (PFJR) addresses the technical challenges of partial knee arthroplasty by providing CT-based pre-operative planning and intraoperative precision. In this interview with Ambre Lucidi, Sébastien Lustig (President of the French Hip and Knee Society - SFHG) discusses how robotic assistance optimizes patellofemoral arthroplasty outcomes.
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Patient Indications & Preoperative Planning
Robotic PFJR targets two primary patient profiles: active patients with isolated patellofemoral osteoarthritis secondary to dysplasia or instability, and elderly patients requiring a low-morbidity procedure. Accurate pre-operative CT imaging is critical for inlay implant sizing and precise trochlear orientation, especially in dysplastic anatomy.
Surgical technique and kinematic restoration
Robotic assistance directly addresses the most critical technical pitfalls of conventional PFJR—implant positioning and soft-tissue balancing—through precise intraoperative navigation:
- Approach & pin placement: Femoral tracker pins are inserted intransgionally through a mid-vastus or sub-vastus approach, minimizing additional soft-tissue trauma.
- Patellar tracking & offset: Robotic navigation allows real-time measurement of the anterior offset. Restoring the exact anterior compartment height avoids trochlear overstuffing, reduces patellofemoral pressure, and mitigates post-operative stiffness or maltracking.
Postoperative strategy
Performed predominantly as an outpatient procedure, successful outcomes rely on a combined protocol of pre-habilitation and 2–3 months of post-operative physical therapy to address pre-existing quadriceps inhibition.
Watch the full interview to master robotic patellofemoral joint replacement!
