Part of Total knee replacement rehab
Kneeling after a knee replacement: what is allowed, and what is possible
Warning signs, and when to get help
Can you kneel after a knee replacement?
For most people, yes, once their own doctor has cleared it.
One question gets asked here, and two are hiding inside it. The first is whether kneeling is allowed, and on that the evidence points one way, with one condition attached to it. A review of everything published on kneeling after this operation found no clinical reason to tell people not to kneel on a replaced knee, as long as kneeling on a rough or uneven surface is avoided, because that can damage the skin over the top and let bacteria in (Wylde and colleagues, 2019). The condition is not a footnote, and the section on what to kneel on below is where it is dealt with. OrthoInfo, the patient library of the American Academy of Orthopaedic Surgeons, says the rest of it in nine words: kneeling is sometimes uncomfortable, but it is not harmful.
The second question is whether kneeling is possible for you, and that one is not settled by evidence at all. It is settled by the front of your knee. Plenty of people with a perfectly good replacement cannot get down onto it, or can and would rather not, and they have usually been given no help with either.
There is a third thing in the way, and it is not the knee. When 75 patients with 100 knees were asked about kneeling at least six months after a first knee replacement, the researchers found that in 54 of those knees the person was steering clear of kneeling out of uncertainty, or because somebody had told them not to, including doctors, nurses and friends (Palmer and colleagues, 2002). The kneelers and the non-kneelers in that study came out the same on every measure of the knee the researchers took. The belief was doing the work, not the joint. If you are reading this because you were told years ago never to kneel on a new knee, that instruction is worth putting back to a clinician instead of keeping it for life.
When can you kneel, and why is there no single week?
No national guidance sets one, so each source you read is quoting its own local practice.
The NHS is specific about the early weeks and it defers to the person who operated on you: do not kneel on the new knee until your doctor says you can. That line comes first, and nothing here replaces it.
For the next step there is a published marker. The review itself points to Versus Arthritis advice that you can try kneeling on a soft surface from 3 months after the operation. The charity, which is now called Arthritis UK, attaches that figure to the scar tissue having healed enough rather than to the date in itself, and it says plainly that kneeling may never be completely comfortable while usually becoming easier. So 3 months is the earliest point at which trying is reasonable for most people, not a day when something switches on.
What your team can see and we cannot is the state of your wound, your scar, your skin and the bend you have. That is why the useful move is a direct question at your check-up: may I start trying to kneel, on a cushion, for a few seconds. It takes a minute to answer and it saves months of guessing. Kneeling is one line on the longer list of things to avoid after a knee replacement, which sets out which of those restrictions end and when.
Will kneeling damage the new knee?
Not according to anything published, and the question has been looked at.
It is worth knowing what kneeling actually does to the knee, because the answer is specific rather than reassuring noise. Kneeling puts an outside load over the kneecap and over the bump of bone just below it, and that load pushes the shin bone backward against the thigh bone. So the question is a fair one. It has been measured. Across a range of replacement designs, the movement between the two metal parts stayed inside the range the implant is built to work through, and slipping or coming apart was found to be highly unlikely. No link has been found between activities that bend the knee deeply, kneeling among them, and the thigh bone component working loose. That is what the review is summarizing when it says there is no clinical reason not to kneel (Wylde and colleagues, 2019).
Two more findings point the same way. Which implant you were given, and whether your kneecap was resurfaced with a plastic button or left as it was, have both been found to make no difference to kneeling ability (Wylde and colleagues, 2019). In the study of 100 knees above, the kneelers and the non-kneelers did not differ in their knee scores, in how far the knee moved, or in whether the kneecap had been resurfaced (Palmer and colleagues, 2002). People who kneel and people who do not are not separated by how good their knee is or by how it was built.
The two real risks sit outside the joint.
The first is your skin. The front of a replaced knee has a scar on it, the skin there is often numb, and numb skin takes damage without reporting it. A graze or a split over a joint replacement is a way in for bacteria, and an infection that reaches a replaced joint is a serious event. OrthoInfo's account of it is worth having straight: a minor infection in the wound area is generally treated with antibiotics, while a major or deep one may need more surgery and removal of the implant. That is the whole reason for the cushion. It protects the skin rather than the implant.
The second is the floor. Getting down to it and back up is where a fall onto a new knee happens, and OrthoInfo warns that a fall in the first few weeks after surgery can damage the new knee and may lead to further surgery. For some readers the floor is a restriction in its own right: if you could not get back up from it before your operation, you should not be getting down onto it now without someone there, however well your knee is doing. Work on that separately with getting up from the floor and the balance and falls prevention program, and treat it as a falls question rather than a knee question.
Why kneeling feels wrong even when it is allowed
Because the skin over your kneecap is not reporting normally, and the pressure is landing on the one part of the knee that was opened.
Numbness around the scar is the rule, not the exception. Of 56 patients assessed a year after a primary total knee replacement, 68 percent reported numbness around the scar, and difficulty kneeling went along with that reported numbness and with worse pain and function scores (Blackburn and colleagues, 2017). Numbness in that study was not linked to a worse result overall, which is worth knowing: a numb patch is not a sign that the operation went badly.
What is taking the pressure is worth being clear about, because it changes how the feeling should be read. Metal and plastic have no nerve supply, so the implant is not the thing you are feeling. Everything around it has one. The load lands on your kneecap and on the bone just below it, and to get into the knee at all the surgeon had to cut through the layer of tissue at the front that works the kneecap and then repair it, which leaves a scar running through working tissue. If your kneecap was resurfaced, the plastic sits on bone that was trimmed down to take it. If it was left alone, your own joint surface is still there and still arthritic, taking the pressure directly. Either way, soreness on that spot is coming from bone, scar and skin, not from the replacement being damaged. That is why it can hurt and be harmless at the same time, which is a hard thing to believe while you are kneeling on it.
For many people the sensation is odd rather than painful. Tight, dead, like kneeling on a coin, like the skin belongs to someone else. Most of that fades slowly over months as the skin resettles, and it is worth expecting the first few attempts to feel strange, because the strangeness is what makes people stop at the first try and never go back.
Nobody should tell you the pain is imaginary, though. What patients report feeling when they kneel runs the whole way from mild discomfort to severe pain (Wylde and colleagues, 2019), and in the interviews with people who still could not kneel years later, pain or discomfort in the replaced knee was the commonest reason of all (Fletcher and colleagues, 2019). An odd feeling, and a knee that is a little sore that evening, are the ordinary experience of this. Severe pain, pain that is still there the next day, or pain that is worse on each attempt rather than easing is a reason to stop and tell your physio or surgical team, not something to push through.
How far the knee bends plays a part too, and the evidence there is mixed. Studies that asked patients about kneeling have found no relationship between the bend and self-reported kneeling ability, while the study that watched patients kneel found that more movement went with better kneeling in every position tested (Wylde and colleagues, 2019; Hassaballa and colleagues, 2004). In the clinic both look true: a very stiff knee cannot reach the position, and a knee with plenty of bend can still be refused by the skin and by the person's own belief. The bend itself belongs with the range work: getting the bend back on a stiff knee and the exercises for weeks 6 to 12, where heel slides, seated knee flexion and the assisted seated knee bend do the work.
How to kneel: what to kneel on, and getting down and back up
Kneel on something that gives, and use your hands and a solid support at both ends of the movement.
None of this starts before your own doctor has said you can kneel on the new knee, which is the NHS instruction higher up this page, and none of it goes onto skin that has not fully healed. If getting down to the floor and back up was already a problem for you before the operation, that is the thing to work on first, with somebody else in the house, using getting up from the floor and the balance and falls prevention program. For you, kneeling starts at the half kneel described below rather than on the floor.
What to kneel on first, since it is the part nobody mentions. A folded towel, a foam kneeling pad, a cushion or a rolled yoga mat all do the job. In clinic we suggest roughly 2 to 5 cm (1 to 2 in) of padding, enough that your kneecap is sitting on something soft and not on a point. Grit, gravel, rough concrete and a tiled floor with a seam running under your knee are the surfaces to keep off, for the skin reason above.
Then the movement, which is where the help usually runs out. The pattern we teach is this:
- Put the pad on the floor first, where the knee is going to land, which is a little behind where your back foot will be. A pad still in your hand when you start is how a first attempt ends up on bare tiles.
- Stand close to something solid and heavy enough to lean on: a chair with arms, a bed, a windowsill, a work surface. Not a wheeled chair and not a wobbly table.
- Put both hands on it and step one foot back. Lower the knee on that back leg slowly down to the pad, never letting it drop the last few inches, and keep your weight in your hands and your front leg the whole way down.
- From there, either stay as you are, which is the half kneel, or bring the other knee down beside it. Going down onto both knees takes away the leg that pushes you back up, so if you are at all unsure about getting up again, stay in the half kneel.
- To come back up, reverse it. Bring one foot forward and flat, put both hands on your support, and push up through your hands and that front leg instead of hauling on the knee. Then stand still for a moment with your hands still on the support before you walk off, because coming straight up from the floor can leave you lightheaded.
One rule runs through all of that: lower yourself onto the pad, never drop onto it. A slow kneel and a heavy landing straight onto the kneecap are not the same load, and the research above is about the first of those. A hard direct blow to a kneecap that has been operated on can crack the bone or tear the tendon mechanism that straightens your leg. Both are uncommon and both are in the warning signs below, and both are avoided by the same thing, which is hands on something solid and the weight coming out of your arms on the way down and on the way up.
Which knee goes down first is worth a thought. If the operated side is the one you can trust least, put the other knee down first and bring the operated one down second, with your hands taking the load. If your other knee is the arthritic one, that may not be an option, which is a good thing to raise with your physio or physical therapist, since the answer depends on what both of your knees can do.
Know what ends an attempt before you make one. Get off the knee, rather than finishing the time you promised yourself, if the pain at the front of the knee is sharp or climbing with every second, if the knee gives way or the leg feels unsafe, or if you feel lightheaded. None of those three means kneeling is finished for you, only that today's attempt is.
The skin is the one that needs more than standing up: if it has split or grazed, clean it and cover it, and use the skin and wound lines in the warning signs below, because broken skin over a replaced joint is a way in for bacteria. Then judge the attempt by the next morning rather than by how it felt at the time. Pain that is still there the next day, or that is worse on each attempt rather than easing, goes to your physio or surgical team instead of into another try.
Build it gradually. A few seconds, once or twice, is a sensible first attempt, and it goes up as the skin and the knee allow. Your physio will adjust this to your knee and to how long you actually need to kneel for. The pain monitoring model is a reasonable way to judge how much discomfort is acceptable while you practice: what matters is how the knee is the next morning, not how it felt at the time. Sit to stand and the mini squat build the thigh strength that getting back up actually needs.
The half kneel, and the jobs you can do without kneeling at all
The half kneel is the position most people should try first, and some will stop there permanently.
One knee on the pad, the other foot flat on the floor in front, weight shared between that foot and the padded knee. It asks for less bend than kneeling on both knees, it keeps one leg ready to push you back up, and you can choose which knee takes the pressure. For weeding, cleaning a low shelf, lighting a fire or playing with a child on the floor, it is often all that was ever needed.
Where kneeling is not going to happen, the task usually bends before the knee does. A low stool or a garden kneeler with handles at the sides. Long handled tools for the garden, and raised beds or pots at waist height if you are planning the garden anyway. A long handled dustpan, and a mop instead of a cloth. Sitting on the floor with your legs out in front, or on a cushion with your back against the wall, which many people find easier than kneeling and nobody suggests. For reaching a low cupboard, bending from the hips with a hand on the counter, or sitting on a chair placed in front of it.
None of that is a defeat. The point of the operation was to get your life back, and a stool is a perfectly good way to get at a low shelf.
If your job, your garden or your prayers need it
Then kneeling is not a lifestyle question for you, and it needs to be on the table before you are discharged rather than after.
The people this hits hardest have been studied. Interviews with 56 patients who still had extreme difficulty kneeling 7 to 10 years after a knee replacement found the problem running through housework, gardening, religious practice, leisure activities and getting up after a fall. They coped with alternatives, with help from other people and with changes at home. Some had accepted it and some were still frustrated by it. The finding that should change how you use your next appointment is this one: few of them had ever discussed kneeling with a health professional, and what they said they had wanted was information about kneeling and physiotherapy afterward (Fletcher and colleagues, 2019).
So ask, and ask specifically. Which positions, how long at a time, what to kneel on, and what to do if the skin complains. If kneeling is part of your paid work, say which tasks and how many hours. NICE guidance on knee replacement says that anyone doing their rehabilitation on their own should be given clear goals and somebody to contact about it, and that supervised outpatient rehabilitation should be offered where a person is having difficulty managing everyday activities, still has a functional problem with specific needs, or is not meeting their goals alone (NICE NG157). Kneeling for a living is a specific need in exactly that sense, and it is a reasonable thing to request rather than a favor.
There are limits to this, and they are worth saying out loud. Nobody can tell you from a distance whether you are fit to return to a kneeling job, because that depends on your knee, on what the work actually involves and on what your employer can change, and it is a conversation between you, your surgical team and your employer. And where a faith practice needs deep kneeling, the position asked for is usually harder than anything described above, so describe it to your physio in detail, including whether you can use a cushion and whether sitting is accepted as an alternative in your tradition.
Why some people never get it back
Because kneeling is consistently the poorest patient-rated outcome after this operation, with 60 to 80 percent of people reporting difficulty kneeling or an inability to kneel (Wylde and colleagues, 2019), and because it is rarely one reason on its own.
The studies do not all land in the same place, and it is worth knowing both. In a cohort of 266 patients having one type of total knee replacement at one hospital, with assessments out to 10 years, pain and function improved substantially and then held, while kneeling ability was reported as much the same after the operation as before it (Wylde and colleagues, 2021). The earlier series of 253 knees is more encouraging: kneeling was poor before surgery, with 80 percent finding it extremely difficult or impossible, and improved in every group afterward, although at 2 years only 20 percent had little or no difficulty (Hassaballa and colleagues, 2003). Put together, they say that kneeling may improve and will probably still be hard. A knee that is far better for walking and for stairs can be no better for kneeling, and that is a known pattern, not a sign that something went wrong with yours.
What stacks up underneath it: skin that stays numb or oversensitive over the scar, pain at the front of the knee on direct pressure, a bend that is short of what the position needs, another painful knee or hip, difficulty getting down to and up from the floor, body weight going through a small area, and the belief, often acquired from a professional, that kneeling is forbidden. Each one is small. Three of them together will stop anybody.
So it is worth one honest attempt, done properly, with a cushion and a solid support, before you accept that kneeling has gone. Nobody needs to watch you try, with one exception: if getting down to the floor and back up is not something you can rely on, have somebody with you for it rather than doing it alone. The study that watched people try is the reason: of 122 patients with a total, partial or kneecap replacement, only 37 percent believed they could kneel, while 81 percent managed it when they were asked to (Hassaballa and colleagues, 2004). Most of those were partial or kneecap replacements rather than total ones, so the exact proportions do not transfer to every reader, but the gap between what people expect and what they can do was large and went in one direction. If pain at the front of the knee is what stops you, knee pain when bending and knee pain when squatting cover the pattern, and the full program sits on total knee replacement rehab.
When kneeling trouble needs checking
Most kneeling trouble is a nuisance and nothing more. Five things are not.
First, and it has nothing to do with kneeling itself, there is the one thing on this page that is a call to emergency services. Sudden breathlessness, chest pain, or coughing up blood after a knee replacement is an emergency call even with a leg that looks perfectly normal. A calf or thigh that is newly swollen, warm or tender needs advice the same day, and so does a leg that is swelling further from week to week instead of settling. Those lines are below, and they are there because a reader who is only a few weeks past this operation is still inside the window the clot advice is written for.
Next, the skin. If you break, graze or split the skin over the knee, clean it and keep an eye on it, and get it looked at the same day if it becomes more red, hot, swollen or painful, starts to leak, or you feel hot, cold or shivery. The same goes at any point in the future, including years later, for a knee that becomes hot, red or swollen along with feeling unwell. A replaced joint can be infected long after the operation, and that is treated urgently. Feeling unwell is not what makes it worth reporting, though. OrthoInfo names increased pain or stiffness in a joint that had been working well among the signs of an infection around a new joint, says the signs can be as little as mild redness and swelling, and says fever is no longer considered a sign of one. Both lines are in the warning signs below with what to do.
Then a fall. If you go down while getting onto or off the floor and cannot put weight on the leg, or the leg looks out of shape, that is an emergency department rather than a phone call, and you should not drive yourself. A smaller knock that leaves the knee newly painful, swollen or bruised still needs checking the same day, even if you can walk on it.
And the knee itself. A knee that has stopped bending or straightening any further from week to week, or that feels unstable or gives way, is a call to your physio or surgical team within a few days rather than a question for your next routine appointment, because a stiff knee is easier to free up early than late. And if you suddenly cannot straighten the knee or lift the leg straight when you could before, that is the same day, and the reason is in the warning signs below.
Last, and this one belongs to the reader whose operation was years ago rather than weeks. Pain in the new knee that had settled and has come back, or pain that is getting worse month by month, is worth a review rather than an emergency call, because the parts of a new joint can loosen or wear over the years and that is found by examining and scanning the knee. Do not file it under kneeling. The routine line below says what to ask for, and when the same pattern needs same-day advice instead.
Discomfort while you kneel, a numb or odd feeling, and a knee that is a bit sore that evening are none of these. They are the ordinary experience of kneeling on a replaced knee, and they are not a reason to stop trying. Severe pain, pain still there the next day, or pain that grows with every attempt is a different thing, and it belongs with your physio or surgical team rather than with another attempt.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: since your operation, you suddenly become short of breath, you get chest pain or pain in your upper back that may be worse when you breathe in, you cough up blood, your heart is beating very fast, or you faint. Call emergency services straight away, even if your leg looks normal. These can be signs of a blood clot in the lungs (pulmonary embolism).
- Emergency: after a fall or a knock, you cannot put weight on the leg, your knee or thigh is very painful, or the leg looks out of shape or shorter than the other. Go to an emergency department straight away, and do not drive yourself. If you cannot get up, call emergency services. A broken bone around a knee replacement is rare, but it needs treatment in hospital. If a smaller fall or knock leaves the knee newly painful, swollen or bruised, even if you can still walk on it and the leg looks normal, stop the exercises, go back to your crutches or sticks and keep your full weight off that leg, and get it checked by your surgical team the same day. A break in the bone around a new knee is not always obvious at first, and walking normally on one can move the broken ends apart.
Get help today
- Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
- Same day: swelling in the operated leg that is increasing from week to week instead of settling, including swelling spreading into your calf, ankle or foot, pain in your leg or calf away from the wound, increasing pain in your calf, or tenderness or redness above or below your knee. Get medical advice the same day. Some swelling is expected for months after this operation, but OrthoInfo lists new or increasing swelling in the calf, ankle and foot, increasing calf pain, and tenderness or redness above or below the knee among its warning signs of a blood clot in the leg, and asks for them to be reported to your doctor rather than watched. Your clot risk does not end on the day your tablets or injections do. If you are also short of breath or have chest pain, call emergency services.
- Same day: your wound becomes more red, hot, swollen or painful, starts to leak or ooze, is still leaking in the second week or has never stopped, has pus coming out of it or its edges start to come apart, or you have a high temperature or feel hot, cold or shivery. Contact your surgical team or get medical advice the same day. Redness can be harder to see on brown or black skin. If you feel very unwell, go to an emergency department. If you have a very high or very low temperature, shivering you cannot control, you are breathing very fast or finding it hard to breathe, you are confused or your speech is slurred, your skin, lips or tongue look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or you have a rash that does not fade when you press it, call emergency services, as this can be sepsis.
- Same day: you break, graze or split the skin over your new knee, and it then becomes more red, hot, swollen or painful, starts to leak or ooze, or you have a high temperature or feel hot, cold or shivery. Clean it and cover it, and contact your surgical team or get medical advice the same day. Redness can be harder to see on brown or black skin. Bacteria entering the bloodstream through a skin infection is one of the ways an infection reaches a replaced knee (OrthoInfo), and an infection around a new joint needs treating quickly. If you feel very unwell, go to an emergency department.
- Same day: since your operation, the redness, warmth, swelling or pain in your knee is not getting better or is getting worse, for example the knee pain keeps building both when you move and when you rest. Contact your surgical team or get medical advice the same day, as this can be a sign of infection around the new joint. If you feel very unwell, go to an emergency department.
- Same day: at any time after your operation, even years later, new pain in your new knee along with a high temperature or feeling hot, cold or shivery, or a knee that becomes hot, red or swollen, which counts on its own, with or without pain and with or without a temperature. Contact your surgical team or get medical advice the same day. A new joint can become infected long after the operation, and that needs treating quickly. A normal temperature is not an all clear: OrthoInfo says fever is no longer considered a sign of an infection after a joint replacement, that the signs can be as little as mild redness and swelling and sometimes there are none at all, and that increased pain or stiffness in a joint that had been working well is one of them. So do not wait for a temperature before you report new or increasing pain in your new knee to your surgical team.
- Same day: you suddenly cannot straighten your knee or lift your leg straight when you could before, often after a pop, a tearing feeling or a stumble, or you notice a dip just above or below your kneecap, or you suddenly cannot put weight on the leg, even without a fall. Keep your weight off it and contact your surgical team the same day. If you cannot reach them that day, go to an emergency department. A tendon at the front of the knee may have torn, and a repair works better when it is done soon.
- Same day: new numbness, tingling or burning in your lower leg or foot, beyond the numb patch of skin around your scar. Contact your surgical team or get medical advice the same day. If it started after a fall or an injury, or your foot or toes turn cold, pale, blue or gray, call emergency services or go to an emergency department straight away, and do not drive yourself.
- Same day: dizziness, lightheadedness, blurred vision or feeling faint when you stand up that is new for you, does not pass within a minute or two, keeps happening, or has made you fall. Sit or lie down, and get medical advice the same day. This can be a drop in blood pressure on standing (postural hypotension), a type of low blood pressure, which the NHS lists among the causes of falls, and your doctor can check it. Tell them about your medicines, because some can cause it. If it does not settle within a few minutes of sitting or lying still, call emergency services. If you faint, call emergency services, even if you come round quickly, because the NHS says to call them when someone faints while exercising or is badly hurt, and a fall onto a new knee can damage it.
Book an appointment
- Within a few days: your knee is not bending or straightening any further from week to week, is getting stiffer, or feels unstable or gives way when you stand or walk. This is not an emergency, but contact your physio or surgical team within the next few days rather than waiting for your next routine appointment, and keep using your walking aid until they have checked it. A stiff knee is easier to free up early than late: where it has to be freed up under anesthetic, doing that earlier, generally within about 6 to 12 weeks of the operation, is associated with regaining more movement than doing it later, although how much any one knee gains also depends on how stiff it was to begin with, on who is suitable and on the rehabilitation afterward. So the date you raise it matters (Hosanee and colleagues, 2026). If the knee has given way and let you fall, or it gives way on stairs, hold a rail and use your walking aid every time, and stay off stairs on your own until you have been seen.
- Within a few days: you have had a fall, even if you were not hurt, or you keep tripping, stumbling or feeling that your legs might give way. Book an appointment with your doctor within a few days and ask about a falls assessment. Tell them about every fall, even the ones where you were not hurt.
- Routine: pain in your new knee that had settled and has come back, or pain that is getting worse month by month, for example pain that starts as soon as you stand up and begin to walk. This is not an emergency, but ask your surgical team for a review, as the parts of a new joint can loosen or wear over the years. Get medical advice the same day instead, not a routine appointment, if the knee also becomes hot, red or swollen, or you have a high temperature or feel hot, cold or shivery, or the pain is building week by week rather than month by month. A new joint can become infected years after the operation, and the two can feel similar at first.
Common questions
Can you kneel after a knee replacement?
For most people, yes, once their own doctor has cleared it. The evidence runs one way on the safety question: the review of kneeling after this operation found no clinical reason to rule it out, as long as kneeling on a rough or uneven surface is avoided, because damaging the skin over the top of a new joint lets bacteria in (Wylde and colleagues, 2019), and OrthoInfo describes kneeling as sometimes uncomfortable rather than harmful. The difficulty is in the doing, not in the permission. One study watched 122 patients try to kneel after a total, partial or kneecap replacement, and while only 37 percent believed they could, 81 percent managed it (Hassaballa and colleagues, 2004). Only 38 of those 122 had had a total replacement, so the proportions do not transfer straight across to a reader who has. If nobody has ever asked you to try, you may not know which group you are in.
When can I kneel after a knee replacement?
There is no national week number, which is why every source you read gives you a different one. The NHS hands the timing to your doctor for the early weeks. The review itself points to Versus Arthritis advice that you can try kneeling on a soft surface from 3 months after the operation, and the charity, now called Arthritis UK, ties that to the scar tissue having healed enough rather than to the calendar. Ask your surgeon or physio at your check-up and take their answer, because they can look at your wound and your scar.
Will kneeling damage my knee replacement?
Nothing in the published work shows that kneeling harms the joint itself, and this has been measured rather than assumed. Kneeling loads the kneecap and the bone just below it and pushes the shin bone backward against the thigh bone. Across a range of implant designs that movement stayed inside the range the implant is built for, slipping or coming apart was found to be highly unlikely, and no link has been found between deep-bending activities including kneeling and the thigh bone component working loose (Wylde and colleagues, 2019). All of that is about kneeling under control, not about dropping onto the knee or landing on it in a fall, which is a different load. The two risks worth managing are different again. The first is your skin: a graze or a split over a replaced joint gives bacteria a way in, which is why what you kneel on matters more than how long you kneel. The second is the floor, because getting down to it and back up is where a fall onto a new knee tends to happen. Both are handled by method rather than by avoidance.
What should I kneel on?
Something that gives under the knee, and never grit, gravel or rough concrete. A folded towel, a foam kneeling pad or a cushion is enough, and in clinic we suggest roughly 2 to 5 cm (1 to 2 in) of padding, enough that the front of your knee is not taking a point of pressure. There is no need to buy anything. Garden kneelers with handles at each side are useful for a different reason, which is that they help you back up.
Is it different after a partial knee replacement?
The evidence is slightly more encouraging and the plan may not be the same. In a series of 253 knees scored before surgery and at 1 and 2 years afterward, the partial replacements gave the best kneeling results and kneecap replacements the worst, though no group kneeled well (Hassaballa and colleagues, 2003). A partial replacement, a revision or a replacement done after a fracture can all come with quite different instructions, so take the timing from your own team, not from a page written around a first total replacement.
What if my job needs me to kneel?
Say so before you are discharged rather than afterward, and say which positions and for how long at a time. NICE guidance on joint replacement asks for rehabilitation goals to be agreed with you and for you to be given a point of contact, and it asks for supervised outpatient rehabilitation to be offered to people who are having difficulty managing everyday activities, who still have a functional problem with specific needs, or who are not reaching their goals on their own (NICE NG157). A job that needs kneeling is exactly that kind of specific need. We cannot tell you whether you are fit for your work, and neither can any website: that is a conversation between you, your surgical team and your employer.
References
- NHS. Recovering from a knee replacement. Page last reviewed 9 September 2026. https://www.nhs.uk/tests-and-treatments/knee-replacement/recovery/
- NHS. DVT (deep vein thrombosis). Page last reviewed 30 April 2026. https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/
- NHS. Low blood pressure (hypotension). Page last reviewed 11 July 2023. https://www.nhs.uk/conditions/low-blood-pressure-hypotension/
- American Academy of Orthopaedic Surgeons. Total knee replacement. OrthoInfo. https://www.orthoinfo.org/en/treatment/total-knee-replacement/
- American Academy of Orthopaedic Surgeons. Infection after joint replacement. OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/joint-replacement-infection/
- Wylde V, Artz N, Howells N, Blom AW. Kneeling ability after total knee replacement. EFORT Open Reviews. 2019;4(7):460-467. https://doi.org/10.1302/2058-5241.4.180085
- Wylde V, Penfold C, Rose A, Bradshaw E, Whitehouse MR, Blom AW. Ten-year results of the Triathlon knee replacement: a cohort study. Cureus. 2021;13(5):e15211. https://doi.org/10.7759/cureus.15211
- Palmer SH, Servant CT, Maguire J, Parish EN, Cross MJ. Ability to kneel after total knee replacement. Journal of Bone and Joint Surgery (British). 2002;84(2):220-222. https://pubmed.ncbi.nlm.nih.gov/11922363/
- Hassaballa MA, Porteous AJ, Newman JH. Observed kneeling ability after total, unicompartmental and patellofemoral knee arthroplasty: perception versus reality. Knee Surgery, Sports Traumatology, Arthroscopy. 2004;12(2):136-139. https://doi.org/10.1007/s00167-003-0376-5
- Hassaballa MA, Porteous AJ, Newman JH, Rogers CA. Can knees kneel? Kneeling ability after total, unicompartmental and patellofemoral knee arthroplasty. The Knee. 2003;10(2):155-160. https://doi.org/10.1016/S0968-0160(02)00148-5
- Blackburn J, Wylde V, Greenwood R, Blom AW, Levy A. The effect of numbness on outcome from total knee replacement. Annals of the Royal College of Surgeons of England. 2017;99(5):385-389. https://doi.org/10.1308/rcsann.2017.0026
- Fletcher D, Moore AJ, Blom AW, Wylde V. An exploratory study of the long-term impact of difficulty kneeling after total knee replacement. Disability and Rehabilitation. 2019;41(7):820-825. https://doi.org/10.1080/09638288.2017.1410860
- Arthritis UK (formerly Versus Arthritis). Knee replacement surgery. https://www.arthritis-uk.org/information-and-support/understanding-arthritis/arthritis-treatments/surgery/knee-replacement-surgery/
- National Institute for Health and Care Excellence. Joint replacement (primary): hip, knee and shoulder. NICE guideline NG157. Published 4 June 2020. https://www.nice.org.uk/guidance/ng157
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-17.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.