Management of the Patella During Total Knee Arthroplasty.

»: The optimal management of the patella during total knee arthroplasty (TKA) remains a controversial topic with no consensus.

»: Patellar management techniques during TKA include patellar retention or resurfacing with or without patellaplasty, as well as circumferential denervation and partial lateral facetectomy (PLF).

»: Special considerations such as patient age, etiology of disease, implant design, and surgeon preference should be accounted for when determining optimal management.

»: We recommend that most patellae be circumferentially denervated, regardless of whether they are resurfaced, as the potential benefits outweigh the small associated risks.

»: Evidence demonstrates improved functional outcomes with the addition of PLF to nonresurfaced patellae. There is currently a paucity of evidence of this technique with respect to resurfaced patellae.

»: Patellar resurfacing adds additional costs and health-care resources that should be considered in the decision-making process.