The Patella in Total Knee Arthroplasty: to Resurface or Not is the Question

Overview

Journal Curr Rev Musculoskelet Med

Date 2014 Apr 8

PMID 24706154

Citations 27

Authors

Matthew P Abdel

Sebastien Parratte

Nicolaas C Budhiparama

Affiliations

Soon will be listed here.

Abstract

The decision to resurface the patella during total knee arthroplasty remains controversial. Even though some surgeons routinely resurface the patella to avoid the increased rates of postoperative anterior knee pain and reoperation for secondary resurfacing, others selectively resurface based on the presence of anterior knee pain, notably damaged articular cartilage, inflammatory arthritis, isolated patellofemoral arthritis, and patellar subluxation and maltracking. The anatomy and biomechanics of the patellofemoral joint, combined with advances in surgical technique and prostheses must be taken into account when making a decision to resurface the patella. Accurate component implantation is imperative for a successful outcome if the patella is resurfaced.

Citing Articles

Save the Patella.

Vasiliadis A, Giovanoulis V, Chytas D, Noussios G SICOT J. 2025; 11:10.

PMID: 39977647 PMC: 11841981. DOI: 10.1051/sicotj/2025004.

Mid-term Outcomes of Patella Resurfacing During Total Knee Arthroplasty (TKA): Clinical, Functional, and Radiographic Insights.

Bajwa S, Aneja K, Rudraraju R, Machaiah P, Bhalodiya H, Singh R Cureus. 2025; 16(12):e75679.

PMID: 39811225 PMC: 11731204. DOI: 10.7759/cureus.75679.

Patella is rarely resurfaced during primary total knee arthroplasty in clinical trials conducted in Greece: a systematic review.

Vasiliadis A, Marin Fermin T, Giovanoulis V, Al-Dolaymi A, Batailler C, Lustig S Arch Orthop Trauma Surg. 2024; 144(8):3649-3655.

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A Crossed Screw Patellar Reconstruction Technique for the Treatment of the Severely Deficient Scaphoid Shaped Patella in Total Knee Arthroplasty.

Poon G, Siow W, Poon K Arthroplast Today. 2023; 24:101259.

PMID: 38023643 PMC: 10665651. DOI: 10.1016/j.artd.2023.101259.

Patellar resurfacing and kneeling ability after total knee arthroplasty: a systematic review.

Shah O, Spence C, Kader D, Clement N, Asopa V, Sochart D Arthroplasty. 2023; 5(1):32.

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References

Nizard R, Biau D, Porcher R, Ravaud P, Bizot P, Hannouche D . A meta-analysis of patellar replacement in total knee arthroplasty. Clin Orthop Relat Res. 2005; (432):196-203. DOI: 10.1097/01.blo.0000150348.17123.7f. View

Pagnano M, Trousdale R . Asymmetric patella resurfacing in total knee arthroplasty. Am J Knee Surg. 2001; 13(4):228-33. View

Sneppen O, Gudmundsson G, Bunger C . Patellofemoral function in total condylar knee arthroplasty. Int Orthop. 1985; 9(1):65-8. DOI: 10.1007/BF00267040. View

Rand J . Patellar resurfacing in total knee arthroplasty. Clin Orthop Relat Res. 1990; (260):110-7. View

Scott W, Kim H . Resurfacing the patella offers lower complication and revision rates. Orthopedics. 2001; 24(1):24. DOI: 10.3928/0147-7447-20010101-11. View

Hwang B, Yang I, Han C . Comparison of patellar retention versus resurfacing in LCS mobile-bearing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2011; 20(3):524-31. DOI: 10.1007/s00167-011-1593-y. View

Ranawat C . The patellofemoral joint in total condylar knee arthroplasty. Pros and cons based on five- to ten-year follow-up observations. Clin Orthop Relat Res. 1986; (205):93-9. View

Dennis D . Isolated patellofemoral arthritis. Orthopedics. 1995; 18(9):893-5. DOI: 10.3928/0147-7447-19950901-35. View

Pavlou G, Meyer C, Leonidou A, As-Sultany M, West R, Tsiridis E . Patellar resurfacing in total knee arthroplasty: does design matter? A meta-analysis of 7075 cases. J Bone Joint Surg Am. 2011; 93(14):1301-9. DOI: 10.2106/JBJS.J.00594. View

10.

Matsuda S, Ishinishi T, White S, Whiteside L . Patellofemoral joint after total knee arthroplasty. Effect on contact area and contact stress. J Arthroplasty. 1997; 12(7):790-7. DOI: 10.1016/s0883-5403(97)90010-3. View

11.

Picetti 3rd G, McGann W, Welch R . The patellofemoral joint after total knee arthroplasty without patellar resurfacing. J Bone Joint Surg Am. 1990; 72(9):1379-82. View

12.

Rhoads D, Noble P, Reuben J, Mahoney O, Tullos H . The effect of femoral component position on patellar tracking after total knee arthroplasty. Clin Orthop Relat Res. 1990; (260):43-51. View

13.

Mochizuki R, Schurman D . Patellar complications following total knee arthroplasty. J Bone Joint Surg Am. 1979; 61(6A):879-83. View

14.

Enis J, Gardner R, Robledo M, Latta L, Smith R . Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee arthroplasty. Clin Orthop Relat Res. 1990; (260):38-42. View

15.

Freeman M, Samuelson K, Elias S, Mariorenzi L, Gokcay E, Tuke M . The patellofemoral joint in total knee prostheses. Design considerations. J Arthroplasty. 1989; 4 Suppl:S69-74. DOI: 10.1016/s0883-5403(89)80010-5. View

16.

Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L . Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand. 2000; 71(3):262-7. DOI: 10.1080/000164700317411852 . View

17.

Bindelglass D, Dorr L . Current concepts review: symmetry versus asymmetry in the design of total knee femoral components--an unresolved controversy. J Arthroplasty. 1999; 13(8):939-44. DOI: 10.1016/s0883-5403(98)90203-0. View

18.

Vielgut I, Kastner N, Pichler K, Holzer L, Glehr M, Gruber G . Application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers. Int Orthop. 2013; 37(8):1465-9. PMC: 3728400. DOI: 10.1007/s00264-013-1933-2. View

19.

Berger R, Crossett L, Jacobs J, Rubash H . Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res. 1999; (356):144-53. DOI: 10.1097/00003086-199811000-00021. View

20.

Nagamine R, Whiteside L, White S, McCarthy D . Patellar tracking after total knee arthroplasty. The effect of tibial tray malrotation and articular surface configuration. Clin Orthop Relat Res. 1994; (304):262-71. View