Evaluation of the Patellar LIFT System for Subjects with Patellofemoral Cartilage Degeneration

Inclusion Criteria:

1. Patients age 22 to 65 years at time of screening

2. Anterior knee pain due to patellofemoral cartilage degeneration (PCD) with anModified Outerbridge score of ≥3 as assessed by an MRI on the study knee

3. Body Mass Index (BMI) of ≤ 35

4. Weight < 300 lbs

5. Anterior Knee Pain Score (AKPS) of ≤ 70 (0-100 scale)

6. Visual Analog Score (VAS) of ≥ 40 (0-100 scale)

7. Failure of at least 6 months of non-surgical treatment defined as at least one ofthe treatments (e.g. rest, bracing, physical therapy, targeted exercise, use ofNSAIDs, activity level reduction or Confidential ZKR Orthopedics, CIP 0001 Page 11of 55 Protocol Version: 1.0, 04JAN2024 modification, etc.) per AAOS Treatment ofOsteoarthritis of the Knee; Evidence based guideline 3rd Edition 2021

Exclusion Criteria:

1. PCD with an Modified Outerbridge Score of 2 or less at the study knee

2. Clinical symptoms of the contralateral knee that preclude activities of dailyliving, stair climbing, stair descending, or require the use of an assist device

3. History of patella dislocation or instability

4. Patella alta or patella baja

5. Known TT-TG distance >20mm

6. Patients requiring simultaneous cartilage grafting procedure, cartilagetransplantation, or bone marrow stimulation

7. Previous repair of a torn patellar tendon

8. Prior TTO procedure or knee joint replacement (total or partial) of the study knee

9. Joint modifying surgery (e.g., ligament reconstruction, meniscus repair, cartilagetransplantation, microfracture, etc.) in the study knee within 6 months prior toplanned index procedure date

10. Arthroscopic surgeries in the study knee for joint lavage, meniscectomy, chondraldebridement, and loose body removal within 3 months prior to planned index procedure

11. Active infection, sepsis, osteomyelitis or history of septic arthritis in any joint

12. Rheumatoid arthritis, other forms of inflammatory joint disease or autoimmunedisorder

13. History of avascular necrosis of any bone

14. History of symptomatic patellar tendonitis of intrasubstance tear

15. Insufficiency of the cruciate, collateral ligaments, or tendon which would precludestability of the LIFT System

16. Pathologic ligamentous injury (Lachman > 1) or meniscus tearing

17. Clinical symptoms of the femoral-tibial joint of the study knee that precludeactivities of daily living, stair climbing, stair descending, or requires the use ofan assist device

18. Evidence (MRI, arthroscopy, etc.) of Modified Outerbridge Grade 4 degenerativearthritis in the femoral-tibial joint of the study knee that potentially explainspatient symptoms