Common controversies in total knee replacement surgery: Current evidence

Table 4 Patella resurfacing vs non-resurfacing in primary total knee replacement

Ref.	Type of study	Outcome
Chen et al[48]	Meta-analysis of randomized controlled trials Patellar resurfacing vs nonresurfacing in primary TKR	Patellar resurfacing reduces the risk of reoperation after TKR. No difference between the 2 groups in terms of anterior knee pain, knee pain score, Knee Society score and knee function score
Pilling et al[44]	Meta-analysis of randomized controlled trials. Patellar resurfacing vs nonresurfacing in primary TKR	The reoperation rate due to anterior knee pain, and the patella-femoral complication rate was significantly higher in the resurfacing group. The knee component of the Knee Society Score was higher in the resurfacing group. No significant difference was observed for the function component of the Knee Society Score or for any other reported knee score
Beaupre et al[43]	Randomized controlled trial. Patellar retention vs patellar resurfacing in primary TKR	No differences among the studied groups
Liu et al[46]	Randomized prospective trial. Patellar reshaping vs resurfacing in TKR	No significant differences between the 2 groups in terms of total Knee Society score, Knee Society pain score, Knee Society function score and anterior knee pain rate
Fu et al[24]	Meta-analysis of randomized controlled trials. Patellar resurfacing vs nonresurfacing	Patellar resurfacing reduce the risk of reoperation after TKR. No difference in anterior knee pain
Breeman et al[39]	Multicenter, randomized controlled trial. Patellar resurfacing or not	No significant difference between the 2 groups regarding functional outcome, reoperation rate, and total health care cost at 5 yr post TKR
Pavlou et al[40]	Meta-analysis of Level-I randomized controlled trials. Patellar resurfacing or not	No significant differences between groups with regard to the incidence of anterior knee pain. Higher rate of reoperations was observed in the non-resurfacing group
He et al[34]	Meta-analysis of randomized trials. Patellar resurfacing or not	Reoperation for patella-femoral problems significantly more likely in the nonresurfacing group. No difference between the 2 groups in terms of anterior knee pain rate, knee pain score, knee society score and knee function score
Burnett et al[37]	Prospective randomized trial. Patella resurfacing vs nonresurfacing in patients undergoing bilateral TKA	No differences regarding the studied parameters
Burnett et al[36]	Prospective randomized trial. Patella resurfacing vs nonresurfacing in patients undergoing bilateral TKA	No differences with regard to range of motion, Knee Score, satisfaction, revision rates, or anterior knee pain

TKR: Total knee replacement; TKA: Total knee arthroplasty.