What's the best way to get back my ability to get up and down off the floor? I'd like to play with my grandchildren. But after a partial knee replacement, I just can't seem to make myself do it.

Many patients are afraid to attempt kneeling on their partial knee replacement. There is a concern that they might damage the new joint. And for those people who can no longer kneel before the surgery, there is the nagging fear that once they get down on the knee, they won't be able to get back up.

Until recently, we weren't even sure why patients couldn't kneel after this surgery. There was wide speculation that it could be the location of the scar, pain, loss of knee motion, and/or numbness from nerve damage. But a study by physical therapists has shed some new light on this problem.

Practice kneeling (getting down and getting up) under the guidance of a physical therapist was very helpful in restoring this valuable skill. The therapist showed them how to kneel on a soft mat using arm support to aid in getting up and down. Kneeling was done on both knees. Limited knee flexion prevented sitting back fully on the heels. The therapist also offered feedback on proper posture and alignment and answered any questions the patients had.

There was no link between scar position, numbness, and range of motion and a change in kneeling ability. Sensitivity of the knee near the kneeling area from nerve injury was unpleasant, but didn't affect kneeling ability. It appears that the key factors were to reduce fear and provide direction on how to kneel safely and easily.

Patient range-of-motion was not significantly different before and after surgery. This finding suggests that a loss of motion is not the reason patients can't or don't kneel after partial knee replacement. And problems in other joints were not a barrier to kneeling. Patients with arthritis in other joints reported being able to kneel using the therapist's suggestions.

For older adults who want to play with grandchildren on the floor, it may be helpful to place yourself close to something you can use to lower yourself down and pull yourself back up. This could be a kitchen chair, the couch, or doorknob or handle. Until you practice enough to become sure of yourself, you may want to stay off the floor slightly. You can use a low chair (also placed strategically so you can get up and down.

But before trying this skill, make sure your orthopedic surgeon approves. Not all implants are designed for kneeling. You may want to schedule a follow-up appointment with the therapist who helped you with your rehab. Having a supervised session may be the best way to accomplish this task safely and easily.

Reference: 

Cathy Jenkins, BSc, MCSP, SRP, et al. After Partial Knee Replacement, Patients Can Kneel, But They Need to Be Taught to Do So: A Single-Blind Randomized Controlled Trial. In Physical Therapy. September 2008. Vol. 88. No. 9. Pp. 1012-1021.

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