The aim of this study was to evaluate the factors affecting kneeling after TKA.
This study included 186 patients who had responded “I need to kneeling in daily activities” in the survey questionnaire (Male：41，Female：145／Age：74.9±6.9／BMI：27.5±4.3). “Kneeling” is generally defined as a stance/movement wherein the knees are placed on the ground. Information about the kneeling situation (possible/impossible) and period to achieve kneeling were obtained in the questionnaire. To analyze the factors related with kneeling achievement, the self-administered questionnaire（original）, range of motion (knee flexion) at 3 postoperative weeks were assessed. To analyze the factors related with kneeling achievement, the multiple logistic regression analysis was applied by the stepwise method. For variables with significant differences, receiver operating characteristic (ROC) curves were calculated, and cutoff values were calculated.
Those who self-responded in the survey that “kneeling is possible” were achieved considered as gainers. According to the questionnaire, 34.9% achieved kneeling after TKA, which took 5.1months to achieve kneeling after TKA. Multiple logistic regression analysis showed that factors affecting kneeling after TKA were pain (p=0.004／Odds Ratio：14.95), fear (p=0.006／Odds Ratio：4.18), and knee flexion angle (p=0.008／Odds Ratio：1.1). The optimal cut-off value for knee flexion was 122.6° in the ROC analysis. The area under the ROC curve was 0.67, and sensitivity and specificity were 79.4% and 45.1%, respectively.
This study showed that kneeling was achieved in 34.9% of patients who requested kneeling, which took 5.1 months postoperatively. Factors associating with kneeling were also shown to be “pain”, “fear”, and “knee flexion angle”. Kneeling can be affected by pain and fear due to the surgical wound and knee swelling in contact on the floor. The present study demonstrated that the knee flexion angle required for kneeling is 122.6°, indicating that a large range of flexion of the knee joint is considered necessary to kneeling without pain.
The results of this study can be applied to patients who wish to kneeling after TKA. The physical therapist should intervene after assessing the cause of the inability to kneeling. Future prospects require intervention studies on kneeling after TKA.
kneeling
pain
