Is Kneeling Possible After Knee Replacement?

X-rays showing prosthetic knees.

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

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.

Will this ability to kneel on the floor be gone after knee replacement surgery?

Research Into Kneeling After a Knee Replacement

In an older study, researchers studied 75 patients (100 knees) at least six months after they underwent a primary total knee replacement. 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.

Overall, the results concluded that:

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

All in all, the results revealed that nearly half of the patients did not even try to kneel and of those who did try, about half experienced discomfort (whether that was related to the knee or not).

Another study examined nearly 250 patients who had undergone various types of knee arthroplasty.

At follow-up one year after surgery, 53 percent of the patients who had undergone unicompartmental knee replacement reported improved kneeling ability versus 41 percent of the patients who had undergone total knee replacement and 28 percent who had undergone patellofemoral knee replacement.

Even so, one year after surgery, only 18 percent of the patients could kneel with little or no difficulty, while the rest struggled.

Like the first study, this study also suggests that many patients were unable to kneel after surgery. Now the question arises, whether this is because they do not want to or because they are physically unable to—an important distinction. The latter study does not delve into this question.

Many Can Kneel But Are Afraid 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.

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

Any difficulty with 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 not likely. In addition, 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 could not do prior to the surgery.

Discuss Kneeling With Your Doctor

You may find that doctors have different opinions on whether it's acceptable to kneel after knee replacement surgery. It also may be that your personal physical condition makes it more or less difficult for you individually to kneel. Some people may even need training or therapy to learn how to kneel properly on their operated knee. All in all, there are likely multiple factors involved in whether or not a person kneels (and how comfortably) after surgery.

While not a great deal of research is 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 to discussing kneeling, 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 activities of daily living.

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Article Sources
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  1. Palmer SH, Servant CT, Maguire J, Parish EN, Cross MJ. Ability to kneel after total knee replacement. J Bone Joint Surg Br. 2002;84(2):220-2. doi:10.1302/0301-620x.84b2.12568

  2. Hassaballa MA, Porteous AJ, Learmonth ID. Functional outcomes after different types of knee arthroplasty: kneeling ability versus descending stairs. Med Sci Monit. 2007;13(2):CR77-81.

Additional Reading
  • American Academy of Orthopedic Surgeons. (2015). Total Knee Replacement. 
  • American Association of Hip and Knee Surgeons. (n.d.). Total Knee Replacement.
  • Jenkins C, Barker KL, Pandit H, Dodd CA, Murray DW. After partial knee replacement, patients can knee, but they need to be taught to do so: a single-blind randomized controlled trial. Phys Ther. 2008 Sep;88(9):1012-21.
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