Uncertainty still exists as to the necessity to resurface the patella in total knee arthroplasty. In a series of 77 ICLH knee arthroplasties there were 12 bilateral cases which had a prior patellar resurfacing on one side and a patelloplasty on the other. The results of those who had a patellar resurfacing were slightly better, but only three patients could tell the difference in their knees. Incidence of patellar fracture following resurfacing was much higher than that following patelloplasty.