Abstract:[Objective] To Introduce the surgical technique and preliminary efficacy of absence of patella and total knee replacement in the treatment of senile fixed patellar dislocation osteoarthritis. [Method] For 4 cases (5 knee) elderly knee osteoarthritis with fixed patella dislocation, total knee replacement (TKA) was cut along the medial patella, the patella was trimmed, degenerated, and the patella cannot be reset, the patella was opened in the lateral sulcus, and the joint capsule was closed after TKA. [Results] All patients completed the operation without intraoperative complications, walking on the first d and no infection in the postoperative wound. Four patients were followed-up for 3 to 5 years, and the last follow-up had stable joints, and the VAS score and HSS score were excellent, but they remained delayed from 10 ° to 25 ° in decubitus position. [Conclusion] For elderly knee OA with fixed patella dislocation, if the functional demand of patients is not high, patella relaxation can be used in TKA, with satisfactory efficacy and can be used as an option for clinical treatment.