• Christoph Becher, Ilias Fanourgiakis, and Heino Kniffler.
• International Center for Orthopedics, ATOS Clinic Heidelberg, Bismarckstr. 9-15, 69115, Heidelberg, Germany. becher.chris@web.de.
• Arch Orthop Trauma Surg. 2023 Dec 1; 143 (12): 713371387133-7138.

AbstractWe present the case of a 35-year-old patient who underwent inlay patellofemoral arthroplasty (I-PFA) followed by secondary patellar realignment surgery and inlay-to-inlay revision. Revision was performed because of ongoing pain, crepitation, and lateral subluxation of the patella. The original patella component (30-mm button) was replaced with a 35-mm dome, while the Hemi-Cap Wave® (7 × 5 mm) I-PFA was replaced with the Hemi-Cap Kahuna® (10 × 5 mm). At the 1-year follow-up, the clinical symptoms were resolved. Radiography revealed an aligned patellofemoral compartment with no signs of loosening. Inlay-to-inlay PFA revision appears to be a reasonable alternative to total knee arthroplasty and conversion to onlay-PFA (O-PFA) for symptomatic patients with primary I-PFA failure. Thorough patellofemoral evaluation and appropriate patient and implant selection are key for successful I-PFA, while additional procedures for patellar realignment may also be required for satisfactory long-term outcomes.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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