Patellar Resurfacing Shows No Clinical Advantage in Propensity-Matched TKA Analysis

Total knee arthroplasty remains the definitive intervention for end-stage osteoarthritis, yet postoperative dissatisfaction persists in a significant subset of patients [1]. A primary driver of this dissatisfaction is residual anterior knee pain, which affects between 4% and 40% of patients following the procedure [2]. To mitigate this, surgeons frequently debate the necessity of patellar resurfacing, a practice intended to optimize patellofemoral mechanics by replacing the articular surface of the patella with a polyethylene component, though the procedure carries its own risk of complications [3]. While some evidence suggests resurfacing reduces the need for secondary operations, the impact on overall functional scores and patient-reported quality of life remains inconsistent across the literature [4, 5]. This clinical uncertainty has led to a lack of consensus on whether to routinely resurface, selectively resurface, or leave the native patella intact [6]. A new propensity-matched analysis now examines how these intraoperative decisions influence patient-perceived outcomes and complication profiles.