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Is Kneeling Possible After Knee Replacement?

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Updated May 08, 2014

Question: Is Kneeling Possible After Knee Replacement?
The kneeling position is essential to many daily living activities and in certain occupations. Kneeling is also an intermediate position used by older adults as they get up from the floor. Clearly, kneeling is a normal movement -- a movement that we take for granted until it's gone.

When is it gone? Can an osteoarthritis patient who has recovered from total knee replacement surgery still kneel? Are they physically able to kneel? Would kneeling damage the joint prosthesis?

Answer: To answer the question, you have to look at it as two questions rolled into one. Can osteoarthritis patients kneel after knee replacement surgery really means -- can they physically kneel and should they kneel?

Patients who have physical limitations from knee osteoarthritis often wonder if knee replacement surgery will give them back movements that have been lost. For example, kneeling, squatting, crossing legs, sitting on the floor with legs folded -- does this all come back after surgery?

Researchers Study Kneeling After Knee Replacement

Researchers studied 100 knees in 75 patients who were attending a follow-up clinic after primary total knee replacement for at least 6 months postop. The knee replacement used in all of the patients was an uncemented prosthesis.

The patients were asked about their ability to kneel and then were asked to kneel on a firm surface while the level of pain on a scale from 0 to 10 was recorded. Those patients unwilling or unable to kneel were asked to explain the reason. There was a group able to kneel without pain or with only mild pain (score 0 to 4) and another group of patients unable to kneel because of pain in the knee (5 to 10). Patients stating they couldn't kneel due to hip or back pain were excluded.

  • 64 patients were able to kneel without pain or discomfort or with mild discomfort only
  • 12 were unable to kneel because of problems which were not related to the knee
  • 24 were unable to kneel because of discomfort in the knee
  • 54 knees avoided kneeling because of uncertainties or recommendations from doctors, nurses, friends

Conclusions About Kneeling After Knee Replacement

Warnings given to patients regarding kneeling seem to be rooted in concern for the prosthesis, but no published data exists concerning this risk. In a previous study, 44% of patients stated that they could kneel, but 82% were actually observed kneeling with no problem. Researchers concluded that fear of harming the prosthesis and lack of information explained why 49% did not kneel.

There seems to be a real difference between perceived and actual ability to kneel -- and for those who don't think they can kneel, fear of harming the prosthesis is the motivating factor.

Bottom Line

You may find that different doctors have different opinions on whether it's acceptable to kneel after knee replacement surgery. It also may be that your own physical condition may make it more or less difficult for you individually. While not a great deal of research is done in this area, it's something for you and your doctor to work out.

Sources:

Ability to kneel after total knee replacement. Journal of Bone and Joint Surgery. Mar 2002. Palmer, SH, et al.
http://www.ncbi.nlm.nih.gov/pubmed/11922363

Can knees kneel? Kneeling ability after total, unicompartmental and patellofemoral knee arthroplasty. Knee. 2003 Jun;10(2):155-60.
http://www.ncbi.nlm.nih.gov/pubmed/12787999

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