Patellar replacement called patellar resurfacing may extend the life of the implant. It has been shown to reduce knee pain after surgery. It can also improve function after total knee replacement (TKR).

There seems to be a higher rate of reoperation for patients with patellar resurfacing. Some doctors think resurfacing should be saved for patients with rheumatoid arthritis or severe pain after surgery. A large or thick patella can also keep a patient from having the patella resurfaced.

Overweight patients and those who have had many knee operations are also not advised to have patellar resurfacing done.