Is patellar resurfacing superior than nonresurfacing in total knee arthroplasty? A meta-analysis of randomized trials

Conflicting results from abundant studies have made it unclear whether the patella should be resurfaced during total knee replacement. A meta-analysis was undertaken to pool the results of randomized controlled studies (RCTs) and to compare the outcomes and postoperative complications after total knee arthroplasty with patellar resurfacing or nonresurfacing. Sixteen RCTs including 3034 knees between 1966 and December 2009 were analyzed. Reoperation for patellofemoral problems was significantly more likely in the nonresurfacing group (P = 0.03). There was no difference between the two groups in terms of anterior knee pain rate, knee pain score, knee society score and knee function score. The results indicate that patellar resurfacing would reduce the risk of reoperation after total knee replacement, but it seems that the benefits are limited on other aspects, and the analysis of high-quality studies shows no advantage of resurfacing over nonresurfacoing group, even in the aspect of reoperation risk. More carefully and scientifically designed RCTs are beneficial and necessary to further prove the results.