Blood supply to the patella. Significance in total knee arthroplasty

Patellofemoral problems occur in approximately 5% of total knee arthroplasties and account for 50% of complications of total knee arthroplasty. Surgical disruption of the blood supply to the patella may cause an increase in the incidence of osteonecrosis, stress fracture, and loosening. The authors discuss patellar blood supply and surgical considerations in total knee arthroplasty and review the clinical experience with avascular patellae.