Selective Patellar Resurfacing: A Literature Review.

Whether to resurface the patella during total knee arthroplasty (TKA) remains a controversial topic among orthopaedic surgeons, and we are still no closer to identifying which technique provides the best outcomes. Advocates for patellar resurfacing have adopted this technique in order to avoid the potential for post-operative anterior knee pain that may be associated with the need for future reoperations. However, reports have indicated that patellar resurfacing may be associated with increased complications such as patellar implant loosening, fracture, osteonecrosis, tendon injury, wear, and instability. More recently, studies have highlighted possible patient-specific and surgical factors, such as weight, body mass index, degree of chondromalacia, and patellar alignment, which may influence functional outcomes, and thus surgical decision making. However, currently there are minimal clear guidelines to help surgeons decide whether or not to resurface the patella. Our aim was to assess the current literature and present the evidence for and against patellar resurfacing, as well as to assess factors that may aid in deciding which procedure is more suitable for the specific patient. Ultimately, we believe there is a need for further research to identify the most appropriate candidates for patellar resurfacing.