Patella in total knee arthroplasty

The patella is a reliable guide to the success or failure of a total knee r eplacement. Patients who do not experience peripatellar symptoms or a patel lar complication usually have a successful result. Conversely, peripatellar symptoms or complications usually reflect an underlying problem with surgi cal technique, component designs, or both. Current designs still do not rep licate normal kinematics, and current instrumentation and techniques signif icantly alter the anatomy of the patellofemoral articulation in a substanti al percentage of patients. Reproducing extensor mechanism balance and using components that provide adequate congruency and contact area through a phy siologic are of motion should lead to a successful result with minimal pate llar symptoms or complications whether or not the patella is resurfaced. At tempting to achieve normal patellofemoral kinematics and minimize patellar complications has led to a better understanding of total knee arthroplasty.