title: After partial knee replacement, patients can kneel, but they need to be taught to do so: a single-blind randomized controlled trial.
abstract: OBJECTIVE
  Kneeling is an important functional activity frequently not performed after knee replacement, thus affecting a patient's ability to carry out basic daily tasks. Despite no clinical reason preventing kneeling, many patients fail to resume this activity. The purpose of this study was to determine whether a single physical therapy intervention would improve patient-reported kneeling ability following partial knee replacement (PKR).
  
  
  METHODS
  Sixty adults with medial compartment osteoarthritis, suitable for a PKR, participated.
  
  
  METHODS
  This was a single-blind, prospective randomized controlled trial. Six weeks after PKR, participants randomly received either kneeling advice and education or routine care where no specific kneeling advice was given. Reassessment was at 1 year postoperatively. The primary outcome measure was patient-reported kneeling ability, as assessed by question 7 of the Oxford Knee Score. Other factors associated with kneeling ability were recorded. These factors were scar position, numbness, range of flexion, involvement of other joints, and pain. Statistical analysis included nonparametric tests and binary logistic regression.
  
  
  RESULTS
  A significant improvement in patient-reported kneeling ability was found at 1 year postoperatively in those participants who received the kneeling intervention. Group allocation was the only factor determining an improvement in patient-reported kneeling ability at 1 year postoperatively.
  
  
  CONCLUSIONS
  The single factor that predicted patient-reported kneeling ability at 1 year postoperatively was the physical therapy kneeling intervention given at 6 weeks after PKR. The results of this study suggest that advice and instruction in kneeling should form part of a postoperative rehabilitation program after PKR. The results can be applied only to patients following PKR.
authors.affiliation: Physiotherapy Research Unit, Nuffield Orthopaedic Centre NHS Trust, Headington, Oxford, Oxfordshire OX3 7LD, United Kingdom. Cathy.Jenkins@noc.anglox.nhs.uk
authors.forename: Cathy
authors.initials: C
authors.lastname: Jenkins
authors.forename: Karen L
authors.initials: KL
authors.lastname: Barker
authors.forename: Hemant
authors.initials: H
authors.lastname: Pandit
authors.forename: Christopher A F
authors.initials: CA
authors.lastname: Dodd
authors.forename: David W
authors.initials: DW
authors.lastname: Murray
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000379:methods* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery; D007720:Knee Prosthesis; D016015:Logistic Models; D008297:Male; D020370:Osteoarthritis, Knee / Q000601:surgery*; D026741:Physical Therapy Modalities; D011187:Posture; D011446:Prospective Studies; D016059:Range of Motion, Articular; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome