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Twenty-seven knees treated between 1974 and 1980 had a total condylar type knee arthroplasty without patellar resurfacing; the average follow-up period was 5.2 years. Compared with a previously reported group of 100 consecutive total condylar arthroplasties, the overall results in this series were very similar. However, there was a significant difference in stair-climbing ability, and one-third of the patients could not use the operated knee for this activity. In most knees the patella could be resurfaced. A working hypothesis assumes that the patellar button can be omitted in (A) patients with relatively normal patellar cartilage, or (B) relatively young, active, or obese patients who are considered a high risk for patellar bone fractures.