A prosthetic patellar implant (100) has a posterior articulation surface (108) and an anterior attachment surface (104). The anterior attachment surface has a medial attachment surface (132) and a lateral attachment surface (134). The medial and lateral attachment surfaces can be planar and angled relative to one another, meeting at an intersection medially offset from the sagittal centerline of the implant. The attachment surfaces can include convexities (254, 256). The anterior attachment surface can have one or more pegs (138) and/or recesses (242, 244). Instrumentation for preparation of a bone includes a first guide (600) having a first collet ( 610) and a second collet for guiding a bone preparation instrument toward the bone. The first and second collets are formed around divergent first (611) and second (613) axes, and share a common opening. A second guide (850) may be carried in the first guide, and another bone preparation instrument inserted through the second guide toward the bone, along a third axis.
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