1. Seventy-seven operations on the patella have been reviewed.

2. There is no evidence that arthritic changes in the femoral condyles are an inevitable sequel of complete excision of the patella.

3. There is a direct relationship between the severity of symptoms after complete excision of the patella and the extent of ossification in the quadriceps tendon.

4. Patello-femoral arthritis after partial excision of the patella may be due to faulty realignment of the patellar ligament and consequent tilting of the patellar remnant towards the femoral condyles.