Patella related problems as common reason for revision of NexGen PS® total knee arthroplasty without patella resurfacing: An analysis of 5911 primary total knee arthroplasties registered in the Dutch Arthroplasty Register

Published:January 11, 2022DOI:



      Patella resurfacing remains controversial in primary total knee arthroplasty (TKA). The aim of this study was to investigate if there was a difference in revision rate and reason for revision within 8 years after single brand primary cemented TKA with or without patella resurfacing, using data from the Dutch Arthroplasty Register.


      All primary TKA surgeries with a posterior stabilized cemented primary NexGen®, between 2010 and 2013 with diagnosis osteoarthritis were analyzed (n = 5911). Multivariate cox regression analyses were performed to analyze differences in revision rate between TKA with or without patella component, and was adjusted for age and previous surgery.


      Of 5911 TKA surgeries, 4795 were performed without patella resurfacing (81.1%) and 1116 with patella resurfacing (18.9%). There was a significant difference in patellar problems as reason for revision between patients after primary TKA with patella resurfacing (9.3%) and without patella resurfacing (29.9%) (p = 0.01). This was mostly caused by patellar pain (28.0%). There was no significant difference in cumulative revision rate within between TKA with patella resurfacing and without patella resurfacing.


      In conclusion, 30% of patients who need revision surgery after TKA using NexGen® PS without patella resurfacing the reason for revision is patella related problems, compared to 9% after TKA NexGen® PS with patella resurfacing. There was no difference in cumulative incidence of revision after primary surgery of all TKA’s using NexGen® PS with or without patella. To reduce the probability of reoperation for patella related problems, our data suggest the patella should be resurface during primary TKA.


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