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Orthopaedics · UK

Kneecap joint replacement, by a consultant knee surgeon.

A bone-preserving patellofemoral joint replacement (PFJR) for isolated kneecap arthritis - a modern NJR-tracked implant, a proper theatre, and a shorter recovery than a total knee replacement when the rest of your knee is genuinely healthy.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private patellofemoral joint replacement costs in the UK.

Indicative ranges across UK private providers.

In short

£10,000–£15,000, home the same day or after one night. NHS-funded via GP referral.

Procedure Indicative range
Patellofemoral joint replacement (private) £10,000–£15,000
Consultation with a knee surgeon £250–£450
Standing knee X-ray + skyline view £150–£300
Knee MRI (both knees if needed) £450–£900
Hyaluronic acid injection (bridging) £350–£700
Steroid injection (bridging) £250–£500

Prices vary by clinic, surgeon, implant (Zimmer Persona PFJ, Stryker Avon, DePuy Sigma PF, Wright Journey PFJ), length of stay and any additional work such as a lateral release.

The problem

The right surgeon, the right implant, the right operation.

Patellofemoral joint replacement is under-offered in the UK - many patients with isolated kneecap arthritis end up with a total knee replacement they did not need. We fix that with proper imaging and a knee surgeon whose practice is patellofemoral.

  • Not sure it is isolated?

    An MRI and a skyline patellar view answer it. If the medial or lateral compartment is worn, a TKR is the honest recommendation.

  • Worried about a big operation?

    PFJR is bone-preserving, day-case or one-night, and rehab starts on day one. It is not a small procedure, but it is a smaller one than TKR.

  • Want it done properly?

    A named consultant knee surgeon with a patellofemoral practice, an NJR-registered implant and an enhanced-recovery pathway - including a straightforward conversion to TKR if you ever need one.

When it helps

When a patellofemoral joint replacement is the right step.

The situations we see most, plus the one clear no - a knee where the rest of the joint is also worn belongs with a total replacement, not a partial one.

  • Isolated patellofemoral osteoarthritis

    Anterior knee pain worse with stairs, inclines and prolonged sitting, with the medial and lateral compartments preserved on X-ray and MRI.

  • Post-traumatic patellofemoral OA

    Kneecap arthritis after an old patellar fracture, dislocation or direct blow - often the classic PFJR case in a 45–65-year-old.

  • OA after recurrent dislocations

    Cartilage loss behind the kneecap after years of dislocation or subluxation, once the joint is stable but painful.

  • Trochlear dysplasia with OA

    A shallow trochlear groove that has led to premature wear - modern implants (Zimmer Persona PFJ, Stryker Avon) accommodate mild dysplasia.

  • End-stage chondromalacia

    Advanced patellar cartilage loss (Kellgren–Lawrence 3–4) that has failed physio, weight loss, offload straps and injections.

  • Failed conservative care

    Persistent pain despite structured physiotherapy, weight optimisation, patellofemoral offload bracing, and HA or steroid injection.

  • Middle-aged, active, bone-preserving

    A patient in their late 40s–60s who wants a bone-preserving alternative to TKR - the tibia and femoral condyles are kept for the future.

  • Not right: whole-knee OA

    If the medial or lateral tibiofemoral compartment is also worn, PFJR is the wrong operation - a total knee replacement is needed.

Procedure options

PFJR is not the only option.

What each option on the table actually involves - and which fits which knee.

  • Patellofemoral joint replacement (PFJR)

    A partial knee replacement that resurfaces only the patella and trochlea. Bone-preserving, day-case or one-night, faster recovery than a TKR.

  • Total knee replacement (TKR)

    The right operation when medial or lateral tibiofemoral compartments are also worn, or when inflammatory arthritis (e.g. RA) is present.

  • Unicompartmental knee replacement (UKA)

    A partial replacement of one tibiofemoral compartment - a different problem from PFJR and not interchangeable.

  • MPFL reconstruction

    For isolated patellar instability without arthritis - a stabilising ligament reconstruction, covered on our /treatments/kneecap-stabilisation page.

  • Tibial tubercle osteotomy (TTO)

    A realignment procedure for maltracking or extreme malalignment - sometimes needed before or with a PFJR.

  • Cartilage repair / microfracture

    Considered for younger patients with focal cartilage lesions - rarely definitive in advanced patellofemoral OA.

  • Physio and injections

    Structured physiotherapy, HA and steroid injections and offload bracing - the mandatory first line, and often enough for mild disease.

Safety and recovery

What to expect afterwards - honestly.

PFJR is a well-established, NJR-tracked partial knee replacement. The things worth planning are your anaesthetic, the rehab window, and knowing what the ten-year numbers actually say.

  • GA plus regional block

    A general anaesthetic with an adductor-canal block is the usual combination - good pain control on day one, and full weight-bearing from the start.

  • Full weight-bearing early

    You will be up on day zero or one with crutches for balance for the first one to two weeks. Range of motion begins immediately.

  • Back to office in 2–4 weeks

    Desk-based work in two to four weeks, driving at four to six, cycling around six, and sport at three to four months.

  • 85–90% ten-year survivorship

    Modern PFJR implants show 85–90% ten-year survivorship in registry data - better than the older generation, though not quite matching TKR.

  • Progression to tibiofemoral OA

    Around 10–15% of PFJRs need conversion to TKR at ten years because the rest of the knee wears out. Conversion is straightforward.

  • Anterior knee pain can persist

    Roughly 15% of patients still feel some anterior knee pain after PFJR. It is the honest number, and worth weighing before surgery.

  • Patellar maltracking

    The kneecap must track through the trochlear groove - occasionally a lateral release or revision is needed to correct maltracking.

  • Infection, DVT, loosening, stiffness

    Prosthetic joint infection, DVT/PE, aseptic loosening, polyethylene wear and stiffness needing manipulation under anaesthetic are all recognised, uncommon risks.

  • Red flags

    Fever, spreading redness, calf swelling, or a hot swollen knee after surgery are not normal - call the clinic or A&E the same day.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever implant was used, the note the surgeon sends you keeps to the same shape.

A UK consultant knee surgeon reviewing a patient’s operation notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the note before your review, just ask.

  1. 01 Header

    Indication and implant chosen

    Why the operation was done - isolated patellofemoral OA, post-traumatic, dysplastic - and which implant (Persona PFJ, Avon, Sigma PF, Journey PFJ) was used.

  2. 02 Technique

    Approach, anaesthetic and fixation

    GA with an adductor-canal block, midline or para-patellar approach, and the trochlear component plus patellar button cemented in place.

  3. 03 Findings

    Cartilage grade and other compartments

    Intra-operative confirmation that the medial and lateral compartments and ACL were intact - the reason PFJR was chosen over TKR.

  4. 04 Impression

    Rehab, restrictions and review timing

    Read this first: weight-bearing status, driving and return-to-sport windows, and when the surgeon wants to see you again.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

PFJR is usually funded by UK PMI when medically indicated and imaging supports isolated patellofemoral OA.

Frequently asked

Everything we get asked about patellofemoral joint replacement.

Quick answers on candidacy, cost, recovery, implant survivorship, and the difference between PFJR and a total knee replacement.

  • What is a patellofemoral joint replacement?

    A partial knee replacement that resurfaces only the back of the kneecap (patella) and the groove it runs in (trochlea). The rest of the knee - the tibiofemoral compartments and cruciate ligaments - is left alone. It is UK NJR-tracked and reserved for isolated patellofemoral osteoarthritis.

  • How is PFJR different from a total knee replacement?

    A TKR resurfaces the whole joint and is used when medial or lateral tibiofemoral compartments are also worn, or in inflammatory arthritis. A PFJR replaces only the kneecap surfaces, is bone-preserving, and has a shorter recovery - but it only works when the rest of the knee is genuinely healthy on X-ray and MRI.

  • Who is the right candidate?

    Typically an older middle-aged patient (roughly 45–70) with anterior knee pain worse on stairs, inclines and prolonged sitting, Kellgren–Lawrence 3–4 patellofemoral OA on the skyline view, preserved medial and lateral compartments on X-ray and MRI, and failure of physiotherapy, weight loss, offload bracing, and HA or steroid injection.

  • When is PFJR not the right operation?

    When any tibiofemoral wear is present (TKR is needed), in inflammatory arthritis such as rheumatoid arthritis, in significant patellar instability without arthritis (an MPFL reconstruction comes first), in extreme malalignment (a tibial tubercle osteotomy may be needed first), and in young athletic patients - where we defer surgery wherever possible.

  • How much does private PFJR cost in the UK?

    Roughly £10,000–£15,000 all-in for the operation, implant, anaesthetic, hospital stay and initial physiotherapy. NHS-funded PFJR is available through referral from your GP.

  • What is the recovery like?

    Full weight-bearing on day zero or one, crutches for balance for one to two weeks, physio-led rehab from day one, desk-based work at two to four weeks, driving at four to six, cycling around six, and return to sport at three to four months. Walking and golf come back early.

  • How long does the implant last?

    Modern implants (Zimmer Persona PFJ, Stryker Avon, DePuy Sigma PF, Wright Journey PFJ) show 85–90% ten-year survivorship in registry series. Around 10–15% of patients need conversion to a total knee replacement at ten years because the rest of the joint wears out - conversion is straightforward because the native tibia and femoral condyles are still there.

  • What are the main risks?

    Prosthetic joint infection, DVT or PE, patellar maltracking (occasionally needing a lateral release or revision), instability, aseptic loosening, polyethylene wear, progressive tibiofemoral OA needing conversion to TKR, persistent anterior knee pain in about 15% of cases, and stiffness needing manipulation under anaesthetic.

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