Analysis of Kneeling Ability after Minimally Invasive Total Knee Arthroplasty

Abstract

In our daily lives, the kneeling movement is very important, especially for individuals in Japan. Total knee arthroplasty (TKA) is an effective procedure for significantly relieving knee pain and improving ambulatory ability, however, many patients are not able to kneel after TKA surgery. We began to perform minimally invasive (MIS)-TKA in September 2010, and we found that not few patients were able to kneel after surgery. Therefore, we have examined the factors which contribute to increased kneeling ability after MIS-TKA with regard to surgical procedure, muscle recovery or range of knee motion.
The present study included 35 knees of 26 patients who underwent TKA in our department between November 2009 and July 2012. TKA revision patients were excluded from this study. To determine which method would be more effective in enabling the patient to kneel after surgery, the subjects were divided into two groups a MIS group and a conventional TKA group and analyzed statistically.
Fifteen knees were treated by conventional TKA, and twenty by MIS-TKA. Kneeling was possible after surgery for 4 knees treated conventionally and 14 knees treated using MIS-TKA. There was a significant difference in kneeling action between the two groups (p<0.05).
MIS-TKA is a technique in which the patella is not everted. It has been reported that everting the patella significantly reduces patellar blood flow. We conclude that not everting the patella in MIS-TKA is one of the factors that facilitate a kneeling action after surgery.