SynthesisBMC musculoskeletal disorders2022
Clinical effectiveness of patellar resurfacing, no resurfacing and selective resurfacing in primary total knee replacement: systematic review and meta-analysis of interventional and observational evidence.
Synthesis in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 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
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 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
- Patellar resurfacing in primary total knee arthroplasty is associated with fewer reoperations but comparable clinical and functional outcomes: an umbrella review of meta-analyses.Arthroplasty (London, England) · 2026Review
- Evaluating the Impact of Patellar Resurfacing in Medial Stabilized Total Knee Arthroplasty: A Retrospective Cohort Study.Orthopaedic surgery · 2026Article
- Circumpatellar Denervation With Patelloplasty in Primary Total Knee Arthroplasty Without Resurfacing: Five-year Outcomes by International Cartilage Repair Society Patellar Cartilage Grade.Arthroplasty today · 2026Article
- Does Patellar Resurfacing Improve Outcomes in Valgus Osteoarthritis with Compromised Patellofemoral Joint Status? A Retrospective Consecutive Comparative Study.Journal of clinical medicine · 2026Article
- Patellar resurfacing as a prognostic variable in total knee arthroplasty: a two‑decade retrospective cohort (2000‑2020).BMC musculoskeletal disorders · 2026Article
- Variation in KOOS JR improvement across total knee implant designs: a cohort study from Michigan Arthroplasty Registry Collaborative Quality Initiative.Acta orthopaedica · 2025Article
- Anterior knee pain is a relevant cause for dissatisfaction after total knee arthroplasty without patellar resurfacing.Journal of experimental orthopaedics · 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
- Optimizing outcomes in total knee arthroplasty: the role of patellar resurfacing and tibial ınsert type.Revista da Associacao Medica Brasileira (1992) · 2025Article
- Article
- New evidence on patella resurfacing in modern total knee arthroplasty for all inflammatory arthritis in a mixed Asian population.Journal of clinical orthopaedics and trauma · 2024Article
- Review
- Fragility analysis and systematic review of patellar resurfacing versus non-patellar resurfacing in total knee arthroplasty.Journal of experimental orthopaedics · 2024Article
- The clinical and cost-effectiveness of elective primary total knee replacement with PAtellar Resurfacing compared to selective patellar resurfacing: a pragmatic multicentre randomized controlled Trial (PART).Bone & joint open · 2024Article
- Development of application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers.Archives of orthopaedic and trauma surgery · 2024Article
- 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
- Primary total knee arthroplasty in hemophilic arthropathy.EFORT open reviews · 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
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatellar resurfacing is optional during total knee replacement (TKR). Some surgeons always resurface the patella, some never resurface, and others selectively resurface. Which resurfacing strategy provides optimal outcomes is unclear. We assessed the effectiveness of patellar resurfacing, no resurfacing, and selective resurfacing in primary TKR.
methodsA systematic review and meta-analysis was performed. MEDLINE, Embase, Web of Science, The Cochrane Library, and bibliographies were searched to November 2021 for randomised-control trials (RCTs) comparing outcomes for two or more resurfacing strategies (resurfacing, no resurfacing, or selective resurfacing) in primary TKR. Observational studies were included if limited or no RCTs existed for resurfacing comparisons. Outcomes assessed were patient reported outcome measures (PROMs), complications, and further surgery. Study-specific relative risks [RR] were aggregated using random-effects models. Quality of the evidence was assessed using GRADE.
resultsWe identified 33 RCTs involving 5,540 TKRs (2,727 = resurfacing, 2,772 = no resurfacing, 41 = selective resurfacing). One trial reported on selective resurfacing. Patellar resurfacing reduced anterior knee pain compared with no resurfacing (RR = 0.65 (95% CI = 0.44-0.96)); there were no significant differences in PROMs. Resurfacing reduced the risk of revision surgery (RR = 0.63, CI = 0.42-0.94) and other complications (RR = 0.54, CI = 0.39-0.74) compared with no resurfacing. Quality of evidence ranged from high to very low. Limited observational evidence (5 studies, TKRs = 215,419) suggested selective resurfacing increased the revision risk (RR = 1.14, CI = 1.05-1.22) compared with resurfacing. Compared with no resurfacing, selective resurfacing had a higher risk of pain (RR = 1.25, CI = 1.04-1.50) and lower risk of revision (RR = 0.92, CI = 0.85-0.99).
conclusionsLevel 1 evidence supports TKR with patellar resurfacing over no resurfacing. Resurfacing has a reduced risk of anterior knee pain, revision surgery, and complications, despite PROMs being comparable. High-quality RCTs involving selective resurfacing, the most common strategy in the UK and other countries, are needed given the limited observational data suggests selective resurfacing may not be effective over other strategies.
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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.