- All right, has your knee been replaced?
Can you kneel on it?
- It's a good question, Bob.
- Yeah, we have an expert to answer your question.
♪ Bob and Brad ♪
♪ The two most famous physical therapist on the internet. ♪
- All right, first we're gonna hear from a surgeon,
Dr. Dane Hansen.
He's from Summit Orthopedics,
and he's gonna answer the question.
And that's what he does, knee surgeries?
- Right, lots of 'em.
This next question I actually had to, I mean,
can you kneel after knee surgery, after a replacement?
- So, you can.
So a knee replacement, you know,
we haven't proven that kneeling
on your knee replacement damages it
or causes any major problems to it.
I would say the vast majority
of people don't really enjoy kneeling.
And the reason is, I think two things,
one is just, you know, you have an implant,
and when you do a knee replacement,
the majority of knee replacements,
you put a new surface on the underside
of your kneecap.
- Kneecap, right.
- And so even though your kneecap is still there
and the bone structure is still there,
that pressure you put on that implant and into the knee
is much different than what your, you know,
your normal knee would do.
And so that's uncomfortable for a lot of people.
And then secondarily, you know, your incision
for your knee replacement is typically right
over the kneecap.
- [Bob] Oh, sure.
- And that can be sensitive,
just because it's some scar tissue there,
and it also causes some numbness in the knee
right around that incision.
And so, it's a much different experience
to kneel afterwards, but you can,
I have plenty of patients that do.
I think probably the best advice is,
if you do need to kneel, or want to kneel
for different things, you know,
if it's working around the house, if it's gardening,
if it's how you, you know,
what you do for work, using pads, you know,
whether it's a foam pad on the ground, wearing knee pads,
I think it'll be much more comfortable that way.
- Are you ever worried about the bone being too thin,
and the patella, and you might break it or not?
- Yes.
That's not uncommon, but you can see patients
when they have really severe knee cap arthritis.
They can erode a large portion of that bone away.
And yes, we do kind of have a minimum thickness
that we need to, you know, to feel comfortable
putting that new surface on.
'Cause you have to drill small little holes
into the bone to hold, you know, for pegs, they're called,
to hold those into place.
And a fractured kneecap is, you know,
one of the worst things that can happen
after knee replacement.
It can really significantly affect function.
They're hard to fix.
You know, I've had a handful, it doesn't happen often,
but I've had a handful where you kinda have to choose
just to leave what's there alone.
And it doesn't drastically affect the function,
but you know, yeah, there are some
of those times where people have gone so far
down the road and haven't dealt with it for so long that,
that bone structure is really damaged.
- Okay, I just did wanna interject here,
historically over the last 25 years of me doing this,
I've had some patients that had to get back
to a job where they're kneeling.
- [Bob] They had to.
- Yep, and I've always said
we need to talk to your surgeon to make sure.
And then the surgeon, most of the time,
- Says yes.
- Yes, exactly what they always say,
"You gotta be careful and knee pads."
If you're just gonna kneel occasionally,
you might wanna just have a nice cushion.
These are our Pete's choice,
we love 'em for many things,
but it's a nice firm cushion and it very comfortable.
And it does really well.
If you lean forward like this, that's not gonna work.
You wanna keep the pressure on the tibial plateau.
- [Bob] Right, stay off the kneecap.
- Right, and so it works out fairly well like this.
So you're gonna be careful.
If you're on a job, like I had one patient,
he was a carpenter, he was on the floor,
and he actually has to,
- Constantly.
- Yep.
- And he had to move while on his knees, you know,
'cause you're not gonna get up and down 300 times
every time you move a section down.
So a good knee,
- Knee pad.
- knee pad,
And you want a good industrial one,
a commercial duty one, something that has a,
you know, you put Velcro on, they go on and off easily.
It's really your choice.
I personally like the ones that have cushion,
and then they have a outer plastic shell
'cause that really spreads.
- It's off the knee cap right?
- Right.
- Yeah, when you bend it, it keeps the force spread out,
and the vast majority goes onto the tibial plateau,
and they're very comfortable.
- They know what they're doing.
- And they typically cost more,
but boy, it's a lot cheaper than a knee.
- Yeah for sure loving, gotta go for it.
- So very good, good luck with kneeling on your new knee
- Good luck with your knee.
- Yeah, be careful.
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