KNEELING ABILITY IN PATIENTS FOLLOWING PRIMARY, UNICONDYLAR AND REVISION KNEE ARTHROPLASTY

Abstract

Aims: To determine the kneeling ability in 3 groups of patients who have undergone either Unicondylar, Primary, or Revision knee arthroplasty.

Methods: A questionnaire was designed to determine the kneeling ability of patients who have undergone knee arthroplasty surgery. The ‘Kneeling’ questionnaire along with a Western Ontario and MacMaster Osteoarthritis Index (WOMAC) questionnaire was sent to 191 patients of whom, 27 have had Unicondylar, 105 had Primary and 59 Revision knee arthroplasty.

Results: The mean follow-up time for assessment for each of the 3 groups of patients were; Unicondylar = 3.32 years, Primary = 5.30 years and Revision = 5.06 years. The mean total WOMAC scores for the 3 groups were; Unicondylar = 13.96, Primary = 22.10, and Revision = 38.67. The percentage of patients who underwent knee arthroplasty that found it impossible to kneel were; Unicondylar = 18%, Primary = 36% and Revision = 66%. The commonest reasons why patients found kneeling difficult were; pain and stiffness around the knee prosthesis, fear of harming the prosthesis and sensory deficit around the knee. Visual Analogue Pain scores for kneeling in the 3 patient groups were, Unicondylar = 5.6, Primary = 7.12, Revision = 9.18. A minimum of 30% of patients in each of the 3 groups reported their daily lives were moderately-severely affected due to their difficulty in kneeling following knee arthroplasty. At least 60% of the patients in each group reported they would like to have better kneeling ability.

Conclusion: Unicondylar knee arthroplasty patients have better WOMAC scores and find kneeling easier than patients who have undergone Primary knee arthroplasty (p< 0.01). The Primary group have better WOMAC scores and find kneeling easier than the Revision group (p< 0.001). Kneeling is considered important in patients who have undergone knee arthroplasty. Poor kneeling ability in patients may restrict their daily activities.