A patella preparation system and method of using a patella preparation system. The patella preparation system includes a fixing device adapted to fixedly hold a patella, a guiding device linked to the fixing device to be moveable relative to the fixing device, preferably by translatory and/or tilting movements/motions, and an operation device for manually moving the guiding device relative to the fixing device individually and separately in a translatory and a tilting manner.

Disclosed herein is a disposable patella clamp. In some examples, the patella clamp is configured as a patient specific patella clamp that is custom designed to fit the anatomy of a particular patient. A patient undergoes diagnostic imaging which provides patient specific data including patella diameter and thickness, patella shape, and limb alignment. The imaging can be used to generate a 3D digital model of the patient's anatomy associated with the patellar region. The patella clamp can be designed and manufactured based on the model as an integrated clamp using an additive manufacturing process with biocompatible materials. The patella clamp may include one or more tracking elements operative to enable the patella clamp to be used with a computer-assisted and/or robotic surgical system.