A system and method for joint arthroplasty may utilize one or more scaffolds to help support an arthroplasty prosthesis for the joint. A natural or prosthetic articulating surface may first be removed from one of the bones of the joint. This may expose a resection surface. A target portion of the resection surface may be identified based on, for example, fit and function testing of the joint with a trial arthroplasty prosthesis in place on the resection surface. One or more scaffolds may be placed on the target portion, and bone cement may be positioned adjacent to the scaffold(s) to define a raised surface that provides better fit and/or function than that which would be obtained with placement on the recessed surface. The arthroplasty prosthesis may be secured to the raised surface through the use of the bone cement.