We measured longitudinal surface strains on the anterior patella at controlled simulated quadriceps loads, quadriceps angles, and knee flexion angles. We studied both the natural patella and patellas resurfaced with domed, bifaceted, and metal backed polyethylene components. Twelve matched pairs of fresh human cadaver knee specimens were tested. Midanterior longitudinal patellar strains were greatest at knee flexion angles at 45 to 60" of knee flexion. Alterations in quadriceps angle medially and laterally did not decrease recorded strain values significantly. Polyethylene patellar prostheses increased patellar strains but a bifaceted component or "total contact" design minimized this effect. Metal support for the prosthetic patella decreased the recorded surface strains. This study of patellar surface strain at the three midline locations provides experimental results that may prove useful for design and validation of analytic models of the patella. The study also suggests that patellar surface strain measures may provide a method for evaluating the effects of patellar prosthesis design and resurfacing procedures.