A comparison of kneeling ability after lateral or midline incisions in total knee arthroplasty

Eur J Orthop Surg Traumatol. 2016 Dec;26(8):915-919. doi: 10.1007/s00590-016-1831-6. Epub 2016 Aug 19.


Kneeling is often impaired following total knee replacement. There is no clinical study comparing a lateral to a midline skin incision with regard to kneeling. Patients with a well-functioning total knee replacement enrolled in the trial. The participants with a lateral skin incision were matched with those with a standard midline incision. Twenty-two patients were enrolled in the study: 10 had a lateral skin incision, and 12 had a midline incision. Those with a lateral skin incision had a significantly higher Forgotten Joint Score than with a midline skin incision (Difference of Means Lateral vs Midline = 10.9 [p value 0.0098]), and an improved ability to kneel at 110 degrees of flexion (Kneeling Ability Test; Difference of Means Lateral vs Midline = 41.7 [p value 0.020]). These results suggest that a lateral skin incision may provide reduced joint awareness and improved kneeling ability. Further investigation with a randomised controlled trial is needed.

Keywords: Incision; Kneeling; Total knee arthroplasty.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Animals
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Arthroplasty, Replacement, Knee* / methods
  • Australia
  • Cicatrix* / etiology
  • Cicatrix* / physiopathology
  • Cicatrix* / prevention & control
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / physiopathology*
  • Male
  • Osteoarthritis, Knee / surgery*
  • Outcome and Process Assessment, Health Care
  • Postoperative Complications* / etiology
  • Postoperative Complications* / physiopathology
  • Postoperative Complications* / prevention & control
  • Range of Motion, Articular
  • Recovery of Function