Kneeling after knee replacement: can you kneel again?

How many people can kneel?

• A review of 36 studies found 36.8% of patients could kneel at least 1 year after surgery, and 47.6% at 3 or more years. Kneeling tends to improve with time.¹
• In a 2026 study of 888 knees, 36% of patients could kneel at 1 year, 42% could squat, and 30% could do both.⁴

It's worth knowing this before surgery. If kneeling matters for your work, faith or hobbies, tell your surgeon early.

Why kneeling is hard

• Sensitivity at the front of the knee. The incision often leaves an area of numbness, tingling or extra sensitivity. In a 2026 study, hypersensitivity and burning or shock-like feelings were linked to kneeling less, and numbness was linked to avoiding it altogether.²
• Pressure. In one study, patients who couldn't kneel felt pain at only 61% of the pressure that people who kneeled easily could handle.³
• Bend and strength. People who could kneel had more knee bend, stronger hamstrings and did better on a sit-to-stand test.⁵

Interestingly, in that last study, fear of damaging the implant was similar between people who could and couldn't kneel, so fear alone didn't explain the difference.⁵ Ask your surgeon whether kneeling is fine for your specific implant once the incision has healed.

Who is more likely to kneel?

In the 888-knee study, people were less likely to kneel or squat if they had a higher BMI, less knee motion before surgery, low confidence about kneeling before surgery, were older, or were women.⁴ Another 2026 study found people who exercised more and cared more about kneeling before surgery kneeled more afterward, often by adapting how they kneel.²

The surgical approach may play a role too. The pooled review found better kneeling odds with shorter incisions and incisions placed slightly to the outer side of the knee, though it called for better trials to confirm this.¹

Tips that help

• Use a thick, cushioned kneeling pad. In a study of 60 patients, nobody rated kneeling "impossible" or "extremely difficult" when using a pressure-spreading pad, and pain went down for nearly everyone who had any.³ See recovery supplies.
• Start on a soft surface like a bed or carpet, and use something sturdy to hold onto.
• Keep working on bend and hamstring strength with your physical therapist.

Does it affect how happy people are with surgery?

Somewhat. In a study of 3,361 patients, improvement in kneeling was one of six things independently linked to being satisfied with knee replacement, alongside pain, limping, night pain, work and stairs.⁶ Overall, 82.9% of patients in that study were satisfied with their knee replacement at 6 months.⁶

Sources

1. Nadeem S, et al. Surgery-related predictors of kneeling ability following total knee arthroplasty: a systematic review and meta-analysis. Knee Surg Relat Res. 2021;33(1):36. doi:10.1186/s43019-021-00117-z
2. Juryn MS, et al. Beyond the surgical factors: preoperative habits, cutaneous sensation, and adaptive strategies as predictors of kneeling ability following total knee arthroplasty. J Arthroplasty. 2026. doi:10.1016/j.arth.2026.09.048
3. Watamori K, et al. Pressure dispersion pad use allows patients to kneel comfortably after total knee arthroplasty. J Exp Orthop. 2025;12(2):e70157. doi:10.1002/jeo2.70157
4. Sethi E, et al. Predictors of inability to kneel and/or squat one year after knee arthroplasty in a Southeast Asian population. J Arthroplasty. 2026. doi:10.1016/j.arth.2026.08.053
5. Arin-Bal G, et al. The role of kneeling ability on post-operative outcomes in total knee arthroplasty. Ir J Med Sci. 2026;195(2):755-761. doi:10.1007/s11845-025-04223-9
6. Martinson ES, et al. Improvement in six of the 12 Oxford Knee Score questions is independently associated with patient satisfaction following knee arthroplasty. Bone Jt Open. 2025;6(8):983-990. doi:10.1302/2633-1462.68.BJO-2025-0105.R1