270 patients (350 knees) undergoing primary total knee arthroplasty due to osteoarthritis were randomized to undergo surgery with or without patellar resurfacing. The purpose of this study was to compare Knee Society scores, incidence of revision and patient-reported satisfaction results of the two techniques up to 2 or 10 years postoperatively. The results of this study demonstrated no statistically significant differences in function, survivorship, or incidence of revision between groups. Patient satisfaction was higher among those who underwent resurfacing when assessed at 2 years, although satisfaction was statistically similar at 10 year follow-up.