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Kneeling ability after total knee replacement

Research output: Contribution to journalArticle

Original languageEnglish
Number of pages8
JournalEFORT Open Reviews
Volume4
Issue number7
DOIs
DateAccepted/In press - 25 Feb 2019
DatePublished (current) - 7 Jul 2019

Abstract

Kneeling ability is consistently the poorest patient-rated outcome after total knee replacement (TKR), with 60–80% of patients reporting difficulty kneeling or an inability to kneel.

Difficulty kneeling impacts on many activities and areas of life, including activities of daily living, self-care, leisure and social activities, religious activities, employment and getting up after a fall. Given the wide range of activities that involve kneeling, and the expectation that this will be improved with surgery, problems kneeling after TKR are a source of dissatisfaction and disappointment for many patients.

Research has found that there is no association between range of motion and self-reported kneeling ability. More research is needed to understand if and how surgical factors contribute to difficulty kneeling after TKR.

Discrepancies between patients’ self-reported ability to kneel and observed ability suggests that patients can kneel but elect not to. Reasons for this are multifactorial, including knee pain/discomfort, numbness, fear of harming the prosthesis, co-morbidities and recommendations from health professionals. There is currently no evidence that there is any clinical reason why patients should not kneel on their replaced knee, and reasons for not kneeling could be addressed through education and rehabilitation.

There has been little research to evaluate the provision of healthcare services and interventions for patients who find kneeling problematic after TKR. Increased clinical awareness of this poor outcome and research to inform the provision of services is needed to improve patient care and allow patients to return to this important activity.

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    Rights statement: This is the final published version of the article (version of record). It first appeared online via The British Editorial Society of Bone & Joint Surgery at https://doi.org/10.1302/2058-5241.4.180085 . Please refer to any applicable terms of use of the publisher.

    Final published version, 614 KB, PDF document

    Licence: CC BY-NC

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