We analysed the results of total knee replacement arthroplasty without patellar resurfacing in 20 patients(28 knees) retrospectively. The patella was not resurfaced when it maintained relatively healthy cartilage in osteoarthritis or the patella was too thin to be replaced in rheumatoid arthritis. The diagnoses were osteoarthritis in 11 and rheumatoid arthritis in 17 cases. The follow up period was 30.3 months in average(12-70 months). A lateral retinacular release was performed in 22 knees(78.6%). The mean knee society score improved from 45.4 preoperatively to 84.1 postoperatively and the functional score improved from 21.4 preoperatively to 63.3 postoperatively. The modified Kujala score was 43.2 points in osteoarthritis and 43.6 points in rheumatoid arthritis. We conclude the total knee replacement arthroplasty without patellar resurfacing shows good results, without high risk of postoperative peripatellar complication.