I’m going to have my left knee replaced because of severe arthritis. The doctor has told me I can keep my own kneecap or get a new one. Which is better?

Studies show a general trend toward better results with kneecap (patellar) replacement during total knee replacement (TKR). Replacing the patella is called resurfacing. Patients with their own patellas (nonresurfaced) are more likely to have knee pain afterwards. The pain is worse when going up and down stairs.

Anyone with good cartilage can keep the patella. Young, active adults who are not obese are good candidates for nonresurfacing. Difficulty tracking the patella up and down over the knee joint is one reason to replace it. Inflammatory changes, abnormal shape, or bone spurs are all good reasons to replace (resurface) the patella.

Ask your surgeon to give you his or her best opinion based on the condition of your kneecap now and the type of implant you’ll be getting.