Knee arthroplasty & osteotomy: a free FRCS (Tr & Orth) Section 1 question

NICE NG157 recommends offering resurfacing of the patella to people having primary elective total knee replacement. The committee's analysis found that routine resurfacing was cost-effective, mainly because it avoids later operations for anterior knee pain: secondary resurfacing is needed in a proportion of knees left unresurfaced and often gives disappointing relief. Selective resurfacing, guided by the state of the cartilage at operation, by pre-operative anterior knee pain or by an inflammatory diagnosis, is widely practised but was not found to be better value than resurfacing every patella. Denervation with patelloplasty is an adjunct for the retained patella and is not recommended in its place. Reference: NICE NG157, Joint replacement (primary): hip, knee and shoulder (2020).