Table 2.

Pearls and Pitfalls of a Minimally Invasive Robotic-Assisted Patellofemoral Arthroplasty

Pearls	Pitfalls
Patient selection is key	Avoid oblique placement or placement of reference pins >3.0, as these can create stress risers/fractures
Pain in the patellofemoral joint
Age
Less than grade 3 changes in medial and lateral compartment
Arthroscopy before confirm candidacy for procedure
Intraoperative positioning crucial to allow full-knee ROM/robot positioning	Soft-tissue balancing needs to be performed in patellofemoral joint to avoid early wear
Use 3.0 reference pins in distal femur	Check soft-tissue balancing before resurfacing patella
Pie-crust medial patella soft tissue after implant placement for soft-tissue balancing	Take care with patella resurfacing as often the lateral facet is deficient secondary to patellar DJD and therefore less resection may be required
When mapping cartilage, ensure probe is down to bone completely through cartilage layer; patella resurfacing is similar to TKA

DJD, degenerative joint disease; ROM, range of motion; TKA, total knee arthroplasty.