Eighty-four patients diagnosed with osteoarthritis and scheduled for a total knee arthroplasty with a posterior-stabilized, fixed-bearing knee system were randomized to receive patellar resurfacing or no patellar resurfacing. Outcomes of interest included the incidence of patellar crepitus (PC), the average time to presentation of PC, the incidence of anterior knee pain, range of motion, the Knee Society Score (KSS), the Oxford score, the Patellar score, and radiographic outcomes. Follow up was performed up to 1 year post-operation. Results revealed significantly lower incidence of PC, and significantly favourable Oxford and Patellar scores at 9 and 12 months, in the patellar resurfacing group compared to the control group. A significantly higher patellar shift index, Insall-Salvati ratio, patellar displacement and patellar height and a significantly lower change in posterior femoral offset was observed in the patellar resurfacing group.