Abstract: Objective:To compare the efficacy of patients with primary knee osteoarthritis undergoing patellar cartilage formation and non-patellar cartilage formation during total knee arthroplasty (TKA). Methods: A prospective study was conducted on the clinical data of total knee arthroplasty performed in our hospital from 2017 to 2019. The patients were randomly divided into a patelloplasty group and a control group. In the patelloplasty group, a pendulum saw was used to remove part of the damaged patellar cartilage, and the surrounding osteophytes were removed and denervated. In the control group ,removal of peripheral osteophytes and denervation treatment. Results were measured by patellofemoral joint trajectory, HSS score, patella feller score, KOOS score, and incidence of anterior knee pain .Results: According to the comparison of feller score, incidence of anterior knee pain, and patellar fit angle, the outcome of patients with patelloplasty was better (P <0.05), and there were significant differences in patellar function and stability. However, the HSS score and patella tilt angle of the patelloplasty group were not statistically significant compared with the control group.Conclusion: During this follow-up, the patelloplasty group was superior to the control group in optimizing patellofemoral trajectory, relieving anterior knee pain, improving function and quality of life. Keywords: total knee arthroplasty, anterior knee pain, patelloplasty