title: Functional outcomes after different types of knee arthroplasty: kneeling ability versus descending stairs.
abstract: BACKGROUND
  Most patients do not kneel following knee replacement and many are of an age when it is not necessary. However, inability to kneel after knee surgery is a frequent cause of dissatisfaction and it is of paramount importance to patients from the East. There are very few studies of this function after knee replacement and none comparing different types of replacement.
  
  
  METHODS
  This study analyzes the kneeling and stair-descending abilities of patients following unicompartmental replacement (UKR), patellofemoral replacement (PFR), and total knee replacement (TKR). Data were prospectively collected on 253 knees (239 patients) that had undergone various arthroplastic procedures for osteoarthritis of the knee. Al1 patients completed the Oxford Knee Score Questionnaire preoperatively and 1 and 2 years postoperatively; thus grading their kneeling ability into 1 of 5 categories.
  
  
  RESULTS
  Only 3% of patients could kneel pre-operatively, while 20% could manage stairs with ease. Post-operatively, 17% of patients could kneel, while 75% could manage stairs with little or no difficulty.
  
  
  CONCLUSIONS
  Many patients remained unable to kneel after one year in all groups. Those who had undergone UKR appeared to perform better than those with TKR or PFR. None of the forms of arthroplasty used resulted in good kneeling ability, though arthroplasty improved this function. On the other hand, stair-descending ability showed a far better improvement. Further work is needed to clarify why patients are unable to kneel, but many factors are involved.
authors.affiliation: University Department of Orthopaedic Surgery, Avon Orthopaedic Centre, Southmead Hospital, Bristol, U.K. mahassaball@aol.com
authors.forename: Mo A
authors.initials: MA
authors.lastname: Hassaballa
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Porteous
authors.forename: Ian D
authors.initials: ID
authors.lastname: Learmonth
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods*; D005684:Gait; D006801:Humans; D007720:Knee Prosthesis; D011446:Prospective Studies; D016059:Range of Motion, Articular; D011795:Surveys and Questionnaires; D016896:Treatment Outcome