Patellar Options in Revision Total Knee Arthroplasty

This chapter presents a case scenario of a 65‐year‐old woman with rheumatoid arthritis who presents with a painful right total knee arthroplasty (TKA) five years after index surgery. Poor patellar bone stock may be encountered at the time of revision TKA. Options such as gull‐wing osteotomy, bone graft augmentation, cemented all‐polyethylene biconvex prostheses, and trabecular metal prostheses have been introduced to address poor patellar bone stock at the time of revision TKA. Surgeons must understand the current evidence before offering a secondary resurfacing to patients with anterior knee pain and an unresurfaced patella. Most modern patellar components are symmetrical domes and compatible with the trochlea of most femoral components. Revision of the patellar component is associated with several complications, including fracture, avascular necrosis, and aseptic loosening. The chapter provides recommendations for implementing evidence‐based practice in the clinical setting.