Is Kneeling Possible After Knee Replacement?

The kneeling position is essential to many daily living activities and is required in certain occupations like carpet laying, painting, and building.

X-rays showing prosthetic knees
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Kneeling is also an intermediate position used by older adults as they get up from the floor and is an essential component of some leisure activities like gardening. Clearly, kneeling is a normal movement—a movement that we take for granted until it's gone.

Does the knee replacement surgery affect our ability to kneel on the floor?

Research: Post-Surgical Kneeling

In a recent study, researchers studied 255 patients (307 knees) who had a primary total knee replacement with the last 18 to 24 months. 

The patients were asked about their ability to kneel, and those who could not kneel were offered help with a kneeling protocol. At the end of the training, they were asked again about their ability to kneel.

Overall, the results concluded that of the 288 knees:

  • 196 knees could kneel without pain or discomfort or with only mild discomfort
  • 77 knees had some difficulty kneeling and could participate in the protocol
  • 43 knees participated in the protocol, and of them, 36 completed all protocols and were able to kneel.

Thus, the results showed that most of the people who had a total knee replacement could kneel after surgery.

Another study examined the role of neuropathic pain in the inability to kneel in 134 knees in patients who had undergone knee arthroplasty.

At the one year follow-up after surgery, 88 percent of the patients had tried to kneel during the post-surgery period. The researchers found no major changes in the patients' ability to kneel before and after surgery.

Younger age, male gender, and decrease in pain score promoted kneeling ability postoperatively. Also, the pain was found to be nociceptive (due to damage to body tissues) rather than neuropathic (due to damage to the nervous system).

Fear of Harming the Prosthesis

The limited research available on this topic suggests 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.

According to the American Academy of Orthopedic Surgeons, kneeling is not harmful to your knee after a total knee replacement, although it may be uncomfortable.

Any difficulty in kneeling (on the knee that was operated on) should become easier with time, but people generally always have the sensation that the knee is artificial and not "normal."

Overall, it's important to remember that the goal of a total knee replacement is an improvement in knee motion, but regaining full knee motion is unlikely.

Also, if you undergo a total knee replacement because of arthritis, it's important to remember that surgery is not going to allow you to do things that you couldn't do prior to the surgery.

Talk to Your Doctor

Doctors have different opinions on whether it's acceptable to kneel after knee replacement surgery. It is possible that your personal physical condition makes it more or less difficult for you to kneel.

Some people may need training or physical therapy to learn how to kneel properly on their operated knee. Thus, there are multiple factors involved in whether or not a person kneels (and how comfortably) after surgery.

While not a great deal of research has been done in this area, it's something for you and your doctor to discuss prior to surgery (and after), so you are clear and realistic on what to expect in terms of your functional abilities.

In addition, be sure to inquire about other activities like climbing stairs, driving, and getting in and out of your car. With surgery and proper physical therapy, you should be able to bend your knee sufficiently to perform these daily activities.

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  1. Wallace SJS, Berger RA. Most Patients Can Kneel After Total Knee Arthroplasty. J Arthroplasty. 2019;34(5):898-900. doi:10.1016/j.arth.2019.01.047

  2. Smith JRA, Mathews JA, Osborne L, Bakewell Z, Williams JL. Why do patients not kneel after total knee replacement? Is neuropathic pain a contributing factor?Knee. 2019;26(2):427-434. doi:10.1016/j.knee.2018.12.009

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