A REVIEW of the Iiterature reveals that fractures of the patella have been treated in the past by a \,ariet\; of methods, some of them simpIe and others characterized by the use of various mechanical contrivances. Too often the end resuIt has been a badly disabIed extremity. In 1877 Lord Lister opened a knee joint and wired together the pateIIar fragments, introducing a method of treatment which had been improved upon but little until the last ten or fifteen years. Many suture materials, including gut, fascia, tendon, silk, wire and the like, and various plates, screws, pins and grafts have been introduced. AI1 of these methods have had their adherents but none of them greatIy improved Lister’s early results. Heineck in 1909 reviewed I, IOO cases of patients with a fractured pateIIa treated by the open method, incIuding thirteen cases of patelIar excision, five for fractures, four for tuberculosis, three for osteomyelitis and one for malignancy. He belie\-ed strongly that open repair was the treatment of choice but concluded that impairment of function and power resulted in these thirteen patients. During the next twenty years there were scattered references to extirpation of the patella but with no definite CrystaIIization of opinion. In 1935 Thomson recommended partial excision of the pateIIa in patients with comminution when there were one large fragment and severa smaIIer fragments; and in 1936 BIodgett and FairchiId reported their experience with fifty-five patients treated by open reduction, twenty of whom had partia1 or tota excision of the patella. It was R. Brooke of EngIand, howexrer, w-ho was IargeIy responsibIe for dissemination of the beIief that the patelIa per se is of neghgible importance in the re-estabIishment of extensor power and function. His impressive resuIts with thirty cases, reported in 1937, in which the pateIIa had been compIeteIy excised and his theory that the pateIIa is but a morphologic remnant phyIogeneticaIIy inherited and of no important function was of considerabIe importance in demonstrating a new approach to pateIIar injuries and their treatment. Groves and WhitnaIl, skeptical at first of Brooke’s opinion, studied various anatomic preparations and on the basis of these studies agreed with his beliefs. In addition, they heIped to cIarify the problem by revealing that it was the suturing of the lateral tendinous expansions of the quadriceps tendon which was the most important. Since announcement of the work by Brooke and Groves, pateIIar excision, either partia1 or tota1, has begun to be rather widely practiced. Dobbie and Ryerson in 1932 reported twenty-one patients treated by tota excision and recommended that al1 of the fragments be excised in those requiring open reduction. Some surgeons now advocate remova of the comminuted fragments only while others recommend complete excision of the patella; some advocate remova of fragments which are separated while others fail to distinguish between those with separation and those without separation; there are those who fail to see any disadvantage with such excision and there are those like Cohn who reported in 1945 the resuIts of his experimental study with rabbits in which he found that compIete pateIIectomy resuIted in “definite pathoIogic changes of the articular cartilage, interpreted as degenera-