Routine patella resurfacing in total knee arthroplasty (TKA) has been the standard management in TKA and is considered the gold standard in most centers worldwide. However, studies have reported comparable long-term results in TKA without resurfacing the patella. When resurfaced, the patella component consists of either full polyethylene (PE) with a button or a more anatomical shape, or is metal backed with or without mobile PE bearings. Despite hypothetical advantages, mobile bearing metal-backed components have yet to prove acceptable outcomes, since considerable problems have been reported, such as increased PE wear, metallosis, fracture, or dissociation (spinout) requiring revision surgery.