Observed kneeling ability after total, unicompartmental and patellofemoral knee arthroplasty: perception versus reality

  • M. A. Hassaballa
  • A. J. Porteous
  • J. H. Newman


Kneeling is an important function of the knee, but little information is available on ability to kneel after different knee arthroplasty procedures. Previous work has asked patients about their kneeling ability; in this study it was objectively assessed. One hundred and twenty two patients — 38 having had total knee replacement (TKR), 53 unicompartmental knee replacement (UKR), 31 patello-femoral replacement (PFR) — were observed trying to kneel at 90° on a chair, at 90° on the floor, and at 120° on the floor. Only 37% of patients thought they could kneel, whereas 81% were actually able to kneel (p <0.001). Ability to kneel on the chair and on the floor at 90°was significantly better than perceived ability for all prosthesis types (p <0.001). Kneeling at 120° showed no difference between perception and reality except for the PFR group (p <0.05). In all positions, increased range of movement significantly improved kneeling ability (p <0.001). Kneeling ability in men was significantly better than in women (p <0.001). Patient-centred questionnaires do not accurately document kneeling ability after knee arthroplasty.


Kneeling Total knee replacement (TKR) Unicompartmental knee replacement (UKR) Patello-femoral replacement (PFR) Range of movement 



The authors wish to thank David Ellwood, Graphic designer, Med-IT, Southmead Hospital, Bristol, UK.


  1. 1.
    Berg P, Mjoberg B (1991) A lateral skin incision reduces prepatellar dyaesthesias after knee surgery. J Bone Joint Surg Br 73-B:374–376Google Scholar
  2. 2.
    Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on perceptions of patients about total knee replacement. J Bone Joint Surg Br 80:63–69Google Scholar
  3. 3.
    Hassaballa MA, Newman JH (2001) Can knees kneel? Kneeling ability after various types of knee arthroplasty. J Bone Joint Surg Br 83 Sup IV:386Google Scholar
  4. 4.
    Hefzy MS, Kelly BP, Cooke TD, Harrison L (1997) Knee kinematics in vivo of kneeling in deep flexion examined by BI-planner radiographs. Biomed Sci Instrum 33:453–458PubMedGoogle Scholar
  5. 5.
    Jensen LK, Eenberg W (1996) Occupation as a risk factor for knee disorders. Scand J Work Environ Health 22:165–175PubMedGoogle Scholar
  6. 6.
    Schai PA, Gibbon AJ, Scott RD (1999) Kneeling ability after total knee arthroplasty. Clin Orthop 367:195–200Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • M. A. Hassaballa
    • 1
  • A. J. Porteous
    • 1
  • J. H. Newman
    • 1
  1. 1.Avon Orthopaedic CentreSouthmead HospitalWestbury-on-Trym, BristolUK

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