Patient reported outcomes and ability to kneel following total knee arthroplasty

Background: Total Knee Arthroplasty (TKA) is an effective treatment for osteoarthritis of the knee. The purpose of this study is to evaluate patient reported outcomes in terms of overall satisfaction, improvement in pain and mobility and ability to kneel following surgery. We examined reasons patients are unable to kneel, assessed the importance of kneeling to patients and considered methods of improving these outcomes by introducing kneeling specific exercises in post-operative rehabilitation. Methods: A retrospective evaluation of 80 patients (102 TKA) was conducted using a 10-point questionnaire. This examined patient demographics and used a 1 to 10 rating scale to indicate patient sentiment with 1 being the lowest and 10 the highest to measure satisfaction ratings (overall/pain/mobility). It also determined whether patients could kneel before and after surgery. Results: Results showed an overall high satisfaction rate, with a total mean score of 8.96/10. Improvement in pain and mobility scores were high (9.1 and 8.79, respectively). 55 % of patients were able to kneel before surgery and 40 % after surgery. 59 % of patients stated that kneeling was important for them. Common activities requiring kneeling including gardening (59 %) and prayer (54 %). Scar pain (54 %) and sensitivity (39 %) were primary impediments to kneeling. Conclusion: This study highlights a high overall satisfaction rate following TKA but kneeling is difficult for many patients. Patients expressed a desire to kneel and we feel that this can be improved by implementing a kneeling specific physiotherapy and education regime, which would address patients fears and help improve outcomes.