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Kneeling after Total Knee Arthroplasty.

Raj M Amin1, Vikram Vasan2, Julius K Oni3

  • 1Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland.

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Kneeling after total knee arthroplasty (TKA) is a common patient goal. Despite no contraindications, patients often avoid kneeling due to complex reasons, limiting functional recovery.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Rehabilitation Medicine

Background:

  • Kneeling is a significant functional goal for patients post-total knee arthroplasty (TKA).
  • Limited research exists on kneeling ability as a primary outcome after TKA.
  • Altered knee biomechanics and diverse TKA designs necessitate understanding kneeling post-surgery.

Purpose of the Study:

  • To review existing literature on patient kneeling ability after TKA.
  • To inform postoperative care recommendations regarding kneeling.
  • To explore factors influencing kneeling post-total knee arthroplasty.

Main Methods:

  • Literature review of studies addressing kneeling after total knee arthroplasty.
  • Analysis of biomechanical data related to knee flexion and joint pressures.
  • Evaluation of clinical outcomes and patient-reported data on kneeling.

Main Results:

  • Elevated patellofemoral joint loads occur at all flexion angles post-TKA.
  • Tibiofemoral pressures increase significantly between 90-120 degrees flexion.
  • Increased range of motion improves kneeling performance in patients who do kneel.
  • Preoperative education has not increased kneeling frequency post-TKA.
  • Patients avoid kneeling for multifaceted, complex reasons.

Conclusions:

  • There is no biomechanical or clinical evidence against kneeling after TKA.
  • Insufficient data exists to recommend specific TKA designs or surgical approaches for optimal kneeling.
  • Musculoskeletal providers should encourage kneeling to maximize patient benefit after TKA.