Functional and radiological outcome of patella resurfacing vs non-resurfacing in total knee replacement

Background: The knee joint is crucial for gait and mobility and osteoarthritis remains its most common debilitating condition. Total knee replacement (TKR) is the standard treatment, though controversy persists regarding patellar resurfacing. While anterior knee pain (AKP) is a leading source of dissatisfaction after TKR, resurfacing carries risks such as subluxation, fracture and loosening. The debate continues, particularly in populations with differing anatomy and lifestyle. To compare functional and radiological outcomes of TKR with versus without patellar resurfacing in a South Indian population. Methods: This prospective comparative study was conducted at IORAS, Madurai, between August 2018 and July 2020. Out of 200 TKRs, 110 patients met inclusion criteria and were evenly divided into two groups: one underwent TKR with patellar resurfacing and the other without. All surgeries were performed by the same surgeon using the Posterior Stabilized Insall Burstein II knee system. Outcome measures included Knee Society Score (pain and function), Feller patellar score and radiographic patellar tilt, with follow-up at one year. Results: At one year, no statistically significant differences were observed between resurfacing and non-resurfacing groups across pain, function, patellar scores or patellar tilt angles (p>0.05). Conclusions: Patellar resurfacing offered no short-term advantage over non-resurfacing in terms of functional or radiological outcomes. Given the complexity of pain perception and lifestyle variability, further long-term studies are warranted. Each TKR case remains unique and modifying a single surgical variable is unlikely to change outcomes significantly.