This study evaluates the short-term results following patellar resurfacing with a trabecular metal patella shell in the setting of marked patellar bone loss at the time of revision total knee arthroplasty (TKA). Twenty consecutive patients undergoing revision TKA with the use of a trabecular metal patella were evaluated at a mean 23-month follow-up. All patients had marked patellar bone loss at surgery precluding resurfacing with a standard cemented patellar button. Results were good or excellent in 17 of 20 patients. There were no displacements of any trabecular metal patella shells, and the fixation appeared excellent despite the poor quality of bone remaining. Complications included 3 patients with polar patella fractures postoperatively. Qualitatively, these results compare favorably with patellar resection arthroplasty in this setting.