When Your Kneecap Gets a New Surface: Patella Resurfacing in Total #KneeReplacement . During a total knee replacement, your surgeon has an important decision to make about your patella (kneecap), resurface it or leave it natural? #Patellaresurfacing is a procedure where the undersurface of your kneecap gets a new, smooth artificial covering: - First, your surgeon makes an incision to access the knee joint and carefully exposes the underside of your patella. The damaged cartilage and a small amou