Rethinking Patellar Replacement: Is It Really Necessary?

Recent meta-analyses and registry data suggest that patients without resurfaced patellae have higher early revision rates and may have more anterior knee pain and lower satisfaction rates. The incidence of patellar resurfacing in total knee arthroplasty varies significantly between countries. Rates in Sweden have fallen from approximately 80% in the 1980s to <5% today. This may be related to the realization that the long-term complications of a resurfaced patella are significant and potentially avoidable. In a young total knee arthroplasty patient, the patellar bone stock should be preserved, whereas there is little reason not to resurface in the older population.