Patellar resurfacing is one of the most contentious issues in total knee replacement, with anterior knee pain ranging from 4 to 49% post TKR. One of the important decision maker in patellar resurfacing techniques is thickness of patella. Minimum 14 mm native patella thickness is essential after 8 mm cut, to avoid patellar complications like loosening, pain and crepitus. We present a study of patellar sizes in Indian population, taken intra-operatively while performing total knee replacement of 73 consecutive knees. We measured thickness, superoinferior and mediolateral dimensions and compared them with height, weight and implant size.The average patellar size in Indian adults was 21.7 mm with 42 knees having patellar size less than 22 mm. In males it was 24.3 mm and in Indian adult females it was 20.8 mm. The patellar size had significant direct correlation with height of the patient. And smaller femoral and tibial implant size correlated with smaller patellar thickness. Average patellar thickness in Indian adults is small. Patelloplasty is a better alternative for such patients than resurfacing.

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