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A landmark 20-year trial published in The Lancet finds that resurfacing the kneecap during total knee replacement (TKR) delivers better patient outcomes and is more cost-effective than skipping the step. Patients who had patellar resurfacing gained significantly more quality-adjusted life-years and had fewer reoperations and complications. Researchers say it's time to make kneecap resurfacing standard care for most TKR patients.
A major 20-year randomized controlled trial published in The Lancet has found that resurfacing the kneecap (patella) during total knee replacement (TKR) leads to better patient outcomes and is highly cost-effective. The study, led by researchers at the University of Oxford, followed over 1,700 patients and found that nearly every clinical measure consistently favored the resurfacing group — from knee function scores to rates of readmission and reoperation.
The resurfaced group gained significantly more quality-adjusted life-years (QALYs) over two decades, and the procedure showed a 99% probability of being cost-effective at any threshold above £10,000 per QALY gained. Researchers concluded that kneecap resurfacing should now be considered standard care for most patients undergoing TKR, a move that could reduce variation in surgical practice across the NHS and beyond.
By the Numbers:
Why it matters: With hundreds of thousands of knee replacements performed annually, standardizing patellar resurfacing could meaningfully improve patient quality of life and reduce long-term healthcare costs at a system-wide scale.
