gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

Patella resurfacing in total knee replacement

Meeting Abstract

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  • corresponding author E. Hille - Allgemeines Krankenhaus Eilbek, Landesbetrieb Krankenhaeuser Hamburg, Abteilung für Orthopaedie und Unfallchirurgie, Hamburg
  • S. Dries - Hamburg
  • F. Lampe - Hamburg

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novEP87

The electronic version of this article is the complete one and can be found online at:

Published: June 13, 2005

© 2005 Hille et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Whether or not to resurface the patella in total knee replacement ist still controversial. A review of the literature, consideration of biomechanical results and the own experience is presented.

Patients, Material and Method

Randomised controlled trials and bilateral comparative trials of the past 15 years were taken into account. Complications reported in these studies are considered regarding severity and necessity for revision surgery. With regard to the biomechanical role of the patella, pathophysiology of patellar maltracking is also considered.


Randomised controlled trials of the 1990s showed better performance of TKR without patellar resurfacing, while studies published in the current decade presented better results with patellar resurfacing. Data from the swedish TKR registry revealed that the revision rate for patellar problems was comparable (0,9% vs. 0,7%) for both approaches, while there were more complex revision procedures after resurfacing.


The patella is an alignment detector. It indicates (by means of pain / radionuclide uptake) whether there is balance or imbalance of the thigh and lower leg. The femoro-tibial alignment turns the balance. Surgery for patellar pain has to focus more on femoro-tibial alignment than on the patellar side. The problem is not to resurface (with the possibility of technical, and certainty of biomechanical failure) or not to resurface the patella, but to consider the kinematic principles by proper alignment of the femoral and tibial implants.