Several options exist for the treatment of the patella during revision total knee arthorplasty. Although extensor mechanism problems are thought to be the leading cause for revision knee arthroplasty, a paucity of good quality evidence exists to guide treatment. There are several factors, however, that can help the surgeon decide how to deal with the patella in a revision setting. These include whether or not the patella was resurfaced during the initial total knee replacement, the type of prosthesis that was used, the presence of anterior knee pain, and existing patellar bone stock.