@article{3084707,
    title = "Secondary patellar resurfacing in total knee arthroplasty - Results of
multivariate analysis in two case-matched groups",
    author = "Karnezis, IA and Vossinakis, IC and Rex, C and Fragkiadakis, EG and and Newman, JH",
    journal = "The Journal of Arthroplasty",
    year = "2003",
    volume = "18",
    number = "8",
    pages = "993-998",
    publisher = "CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS",
    issn = "0883-5403",
    doi = "10.1016/S0883-5403(03)00286-9",
    keywords = "patella; resurfacing; total knee arthroplasty",
    abstract = "Although patellofemoral symptoms after patellar-retaining knee
arthroplasty are common, no evidence has been published in the
literature on the potential benefit from patellar resurfacing at a later
stage. This study evaluates the effect of secondary (delayed) patellar
resurfacing using comparisons between 2 case-matched groups of patients
with primary and secondary patellar resurfacing. Furthermore,
multivariate statistical methods were applied to study factors that may
influence the final outcome. our results suggest that although
significant clinical improvement was seen after delayed patella
resurfacing, the outcome of secondary patellar resurfacing is inferior
to that expected for a similar group of patients with primary
resurfacing. Furthermore, the timing (delay period) of the secondary
resurfacing procedure appears to negatively affect the final outcome.
This suggests that secondary patellar resurfacing, when indicated,
should be considered at an early stage."
}