Patella Resurfacing in Total Knee Arthroplasty: The Sum of All Parts

Patellar resurfacing during total knee replacement remains controversial despite being commonplace in the United States. Patella complications occur in 1 to 12% of all total knee arthroplasties (TKAs) and are the second most frequent reason for reoperation after sepsis. Problems such as subluxation and tilt of the patella, anterior knee pain, patella dislocations, polyethylene wear, patellar fractures, and component loosening have been extensively examined in the literature and by our institution. We have found that patellar implantation is dependent on several steps during TKA, some involving the patella directly and many that do not. Successful patellar implantation, therefore, should be considered the sum of all parts in TKA reconstruction.