ReviewJournal of orthopaedic surgery and research2021
Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacing.
Review in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Functional outcome and cost effectiveness of patellar resurfacing and non-resurfacing in total knee arthroplasty: systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Patella is rarely resurfaced during primary total knee arthroplasty in clinical trials conducted in Greece: a systematic review.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Different modalities of patellar management in primary total knee arthroplasty: a Bayesian network meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2024Pooled it
- Impact of osteoarthritis aetiology and implant constraint on the risk of secondary patellar resurfacing after total knee arthroplasty: An analysis of German Arthroplasty Registry (EPRD) data.Journal of experimental orthopaedics · 2026Article
- Patellar resurfacing as a prognostic variable in total knee arthroplasty: a two‑decade retrospective cohort (2000‑2020).BMC musculoskeletal disorders · 2026Article
- Kinematic alignment in total knee arthroplasty restores the native anatomy, with a joint line parallel to the ground on a standing view.Journal of orthopaedics · 2025Article
- Clinical outcomes of intramedullary tibial guides in total knee arthroplasty: experience from a single-centre cohort.Journal of orthopaedic surgery and research · 2025Article
- Clinical outcomes of a 'patella-friendly' medial pivot total knee arthroplasty with and without patella resurfacing: A prospective randomised study.Journal of orthopaedics · 2025Article
- Coronal plane alignment changes do not affect outcome for total knee implant design with 3 degree varus joint line.Journal of orthopaedic surgery and research · 2025Article
- Patellar resurfacing in contemporary total knee arthroplasty: Frequency of complications in a matched cohort.Journal of orthopaedics · 2025Article
- A Single Surgeon Experience of Selective Patellar Resurfacing During Primary Total Knee Arthroplasty.Arthroplasty today · 2024Article
- Circumferential patellar denervation does not reduce anterior knee pain in total knee arthroplasty without patellar resurfacing; a prospective comparison.Journal of orthopaedic surgery and research · 2024Observational
- Review
- Fragility analysis and systematic review of patellar resurfacing versus non-patellar resurfacing in total knee arthroplasty.Journal of experimental orthopaedics · 2024Article
- Review
- When to Do Selective Patellar Resurfacing in Total Knee Arthroplasty: A Decision-Making Algorithm Based on Pre-operative and Intra-operative Findings.Indian journal of orthopaedics · 2024Article
- A Crossed Screw Patellar Reconstruction Technique for the Treatment of the Severely Deficient Scaphoid Shaped Patella in Total Knee Arthroplasty.Arthroplasty today · 2023Article
- Periprosthetic patella fractures in total knee replacement and revision surgeries: how to diagnose and treat this rare but potentially devastating complication-a review of the current literature.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Review
- Patella resurfacing is not associated with a difference in the Oxford knee score after total knee arthroplasty but stair descent is enhanced.Archives of orthopaedic and trauma surgery · 2023Article
- Patellar resurfacing and kneeling ability after total knee arthroplasty: a systematic review.Arthroplasty (London, England) · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe decision to resurface the patella as part of total knee arthroplasty may be influenced by the surgeon's preference, education, training, tradition and geographic location. Advocates for non-resurfacing or selectively resurfacing may claim no difference in patient reported outcomes, and that resurfacing is associated with increased risks such as extensor mechanism injury or malalignment, problems with the design of the patella component and technical issues intraoperatively.
aimsTo critically examine factors that should be considered in addition to patient reported outcomes in the decision process of resurfacing or non-resurfacing of the patella in total knee arthroplasty.
methodA comprehensive literature search was conducted to identify factors that may influence decision making in addition to knee specific patient reported outcome measures such as surgical risks, patient quality of life, procedure cost, re-operation rate, implant design, surgeons learning curve and the fate of remaining cartilage in native patellae.
resultsPatient-reported outcomes are equivocal for resurfacing and non-resurfacing. Critical analysis of the available literature suggests that the complications of resurfacing the patella are historic, which is now lower with improved implant design and surgical technique. Routine resurfacing was cost-effective in the long term (potential saving £104 per case) and has lower rates of revision (absolute risk reduction 4%). Finally, surgical judgment in selective resurfacing was prone to errors.
conclusionPatella resurfacing and non-resurfacing had similar patient-reported outcomes. However, patella resurfacing was cost-effective and was associated with a lower rate of re-operation compared to non-resurfacing.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.