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Stress Over the Anterior Aspect of the Knee with Kneeling
Wayne M. Goldstein, MD; Alexander C. Gordon, MD; Jill Jasperson Branson, RN, BSN; Chris Simmons, BS; Kimberly A. Berland, CST, FA
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (royalties, DePuy). Also, a commercial entity (DePuy) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or non-profit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Oct 01;89(suppl 3):162-166. doi: 10.2106/JBJS.G.00482
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Many patients inquire if they will be able to kneel after total knee arthroplasty. We have cautioned patients regarding issues related to the patella that are associated with kneeling, yet, despite discomfort, many continue to kneel during various activities around the home or for religious reasons. While new high-flexion knee implant designs allow patients to get lower to the ground, the acts of cleaning a floor, gardening, exercising, and kneeling in prayer require bending down on both knees, and patients often state that they cannot kneel after total knee arthroplasty because of pain or that they do not attempt to kneel because the position feels awkward. Kneeling is part of daily life in certain cultures and, as elderly patients are more active, it is becoming an activity of increasing interest. Kneeling can be divided into three positions: kneeling at <90° (for example, while praying on a riser in a place of worship), kneeling at 90° (for example, while gardening or scrubbing a floor), and kneeling at full flexion (for example, while praying on the floor).
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