Patello-Femoral Syndrome (PFS) is a condition that causes pain in and around the kneecap (patella). In the normal, healthy adult, the patella moves smoothly over a groove on the femur (thigh bone). PFS can develop when the patella is not moving or tracking properly over the femur. This is a common knee problem in runners and athletes but anyone can be affected.
Where the patella and femur meet forms a joint called the patellofemoral joint. Many muscles and ligaments control this joint. Any change in alignment of the bone, ligaments, and/or muscles around the patellofemoral joint can affect how the patella tracks along the femoral groove.
Patellofemoral joint replacement is usually a treatment for patients with severe osteoarthritis. The articular cartilage covering the back of the kneecap becomes worn and torn causing painful movement. Replacing the patellofemoral joint in PFS doesn't address the real problem of soft tissue imbalance and structure causing tracking problems.
Conservative treatment for PFS with bracing and exercise may be the best option. If the back of the patella has worn more on one side than the other from the uneven forces of PFS, then the surgeon can smooth the surface without replacing the entire bone. An orthopedic surgeon is the best person to look at your situation and advise you about treatment options including patellofemoral replacement.