Between 1990 and 2003, 24 patients (28 knees) who had a total knee arthroplasty (TKA) and underwent subsequent patella resurfacing without revision of the tibial or femoral components to alleviate pain were identified. Patient charts were reviewed retrospectively and patients were interviewed after average 2.9-year follow-up (range: 1-12 years) to assess function, pain, and satisfaction with the procedure. Average patient age at revision surgery was 68 years, and the average time from the index TKA was 9.8 years. Mean Knee Society function and pain scores were 68+/-28 and 45+/-16, respectively. Average preoperative range of motion was 102 degrees (range: 65 degrees-130 degrees), and average postoperative range of motion was 106 degrees (range: 65 degrees-130 degrees). Only 52% of patients would undergo revision surgery again given their current levels of pain and function. Revision of only the patella for patients with a painful TKA who did not undergo patella resurfacing at the initial surgery provides 52% satisfactory results. Surgeons should look for other causes of pain in this patient population and reconsider their indications for not resurfacing the patella in TKA.