Outcome after total knee arthroplasty with or without patellar resurfacing

M. Shahbaz Siddiqui, Vivek Kumar Parsurampuriya, Neeraj Kumar, Sumedh Kumar


Background: Patellar resurfacing in total knee arthroplasty has had its defenders and detractors. There seems to be a great difference in patellar resurfacing between countries and patellar resurfacing is still controversial. Some surgeons resurface the patella routinely, others not at all, and a third group prefers selective resurfacing. Therefore, in this prospective and randomised study, we compared the outcome after total knee arthroplasty with or without patellar resurfacing.

Methods: In this study 50 cases (100 knees) were selected and each case was followed up for 2 years. In each case, one knee was operated by TKA with patellar resurfacing and the other by TKA with patellar non-resurfacing. Patients were followed-up for a period of 2 years and clinical and functional outcome of both knees was measured and compared by the help of knee society score (KSS) and VAS score.

Results: There was statistically significant difference between the patellar resurfacing and non-resurfacing group with regard to knee society score, pain score and visual analogue score (VAS), with the patellar resurfacing having better scores. There was no significant difference in the functional scores between the 2 groups. Range of motion was complication rate was comparable in both the groups. However, there was no case of reoperation nor was there any complication related to the patellar implant. 

Conclusions: Patellar resurfacing in TKA leads to less post-operative persisting knee pain, and also leads to better outcome in terms of walking without pain, using stairs without pain and rest pain as compared to TKA without patellar resurfacing.


Total knee arthroplasty, Patelloplasty, Patellar resurfacing, Knee score, Knee functional score, KSS, VAS

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Berger RA, Rosenberg AG, Barden RM, Sheinkop MB, Jacobs JJ, Galante JO. Long-term follow-up of the Miller-Galante Total knee replacement. Clin Orthop Relat Res. 2001;388:58-67.

Pakos EE, Ntzani EE, Trikalinos TA. Patellar resurfacing in total knee arthroplasty: A meta-analysis. J Bone Joint Surg Am. 2005;87:1438-45.

Waters TS, Bentley G. Patellar resurfacing in total knee arthroplasty: A Prospective, Randomized Study. J Bone Joint Surg Am. 2003;85-A2:212-7.

Ali A, Lindstrand A, Nilsdotter A, Sundberg M. Similar patient-reported outcomes and performance after total knee arthroplasty with or without patellar resurfacing. Acta Orthop. 2016;87:274-9.

Rand JA. The patellofemoral joint in total knee arthroplasty. J Bone Joint Surg Am. 1994;76:612-20.

Harwin SF, Stein AJ, Stern RE. Patellofemoral resurfacing at total knee arthroplasty. Contemp Orthop. 1979;145:68-77.

Barrack RL, Bertot AJ, Wolfe MW, Waldman DA, Milicic M, Myers L. Patellar resurfacing in Total Knee Arthroplasty. A prospective, randomized, double-blind study with five to seven years follow-up. J Bone Joint Surg Am. 2001;83:1376-81.

Schroeder-Boersch H, Scheller G, Fischer J, Jani L. Advantages of Patellar resurfacing in total knee arthroplasty. Two-year results of a prospective, randomized study. Arch Orthop Trauma Surg. 1998;117:73-8.

Feller JA, Barlett RJ, Lang DM. Patellar resurfacing versus retention in total knee arthroplasty. J Bone Joint Surg Br. 1996;78:226-8.

Bourne RB, Rorabeck CH, Vaz M, Kramer J, Hardie R, Robertson D. Resurfacing versus not resurfacing the patella during total knee replacement. Clinic Orthop. 1995;321:156-61.

Newman JH, Ackroyd CE, Shah NA, Karachalios T. Should the patella be resurfaced during total knee replacement? Knee. 2000;7:17-23.

Park SJ, Jung YB, Jeong HJ, Shin HK, Jung HJ, Lim JJ, Yoon JW, Kim E. Long-term results of primary total knee arthroplasty with and without patellar resurfacing. Acta Med Okayama. 2010 Oct;64(5):331-8.

Burnett RS, Boone JL, McCarthy KP, Rosenzweig S, Barrack RL. A prospective randomized clinical trial of patellar resurfacing and nonresurfacing in bilateral TKA. Clin Orthop Relat Res. 2007 Nov;464:65-72.

Wood DJ, Smith AJ, Collopy D, White B, Brankov B, Bulsara MK. Patellar resurfacing in total knee arthroplasty: a prospective, randomized trial. J Bone Joint Surg Am. 2002;84-A(2):187-93.