Can you kneel after a Stryker (total knee arthroplasty) replacement?

Kneeling After Stryker Knee Replacement

Yes, you can kneel after a Stryker knee replacement, but many patients avoid it due to discomfort, numbness, or fear of damaging the prosthesis rather than actual clinical contraindications.

Understanding Kneeling Ability After Total Knee Arthroplasty

Kneeling is consistently reported as one of the poorest patient-rated outcomes following total knee replacement (TKR), with 60-80% of patients reporting difficulty kneeling or an inability to kneel 1. However, research shows a significant discrepancy between patients' perceived ability to kneel and their actual ability.

Key Research Findings:

• Studies show that many patients who believe they cannot kneel are actually physically capable of doing so when asked to demonstrate 2
• In one study, 64 out of 100 knees could kneel with no or mild discomfort, yet many patients avoided kneeling due to uncertainties or recommendations from healthcare providers 2
• There is no biomechanical or clinical evidence contraindicating kneeling after TKA 3

Reasons Patients Avoid Kneeling

The reluctance to kneel after knee replacement is multifactorial:

• Knee pain or discomfort
• Numbness around the knee (common after surgery)
• Fear of damaging the prosthesis
• Recommendations against kneeling from healthcare providers
• Comorbidities unrelated to the knee replacement
• Lack of education about kneeling safety

Biomechanical Considerations

While kneeling does place increased pressure on the knee joint:

• Patellofemoral joint pressure is elevated at all flexion angles
• Tibiofemoral articulation pressures are elevated only at 90-120 degrees of flexion 3
• These increased pressures are rarely problematic for prosthetic knees because modern implants are designed to withstand normal activities

Rehabilitation Guidelines

Based on current evidence, the following approach to kneeling after knee replacement is recommended:

1. Early Mobilization: Begin knee mobilization immediately after surgery to improve range of motion, which correlates with better kneeling ability 4

2. Weight Bearing: Progress to immediate weight bearing as tolerated, which has been shown to decrease anterior knee pain without affecting knee laxity 4

3. Strength Training: Incorporate both closed kinetic chain (CKC) and open kinetic chain (OKC) exercises to rebuild strength 4

4. Gradual Kneeling Progression:

   • Start with supported kneeling (using a chair for support) once surgical wounds have healed
   • Progress to kneeling on soft surfaces before attempting harder surfaces
   • Use knee pads or cushioning when kneeling to reduce discomfort

Common Pitfalls to Avoid

1. Avoiding kneeling altogether: This can lead to unnecessary functional limitations in daily activities, religious practices, and work

2. Kneeling too early: Wait until surgical wounds are completely healed (typically 6-8 weeks) before attempting to kneel

3. Lack of education: Many patients avoid kneeling due to misconceptions about damaging their prosthesis

4. Ignoring pain: While some discomfort is normal, sharp or severe pain during kneeling should prompt evaluation

Conclusion

Kneeling after a Stryker knee replacement is physically possible and not contraindicated. The primary barriers are psychological (fear of damage) and sensory (discomfort or numbness) rather than mechanical limitations of the prosthesis. Proper education, gradual progression, and appropriate techniques can help patients return to kneeling activities that are important for their quality of life.