Factors influencing return to work after hip and knee arthroplasty

Abstract

BackgroundA substantial proportion of patients undergoing lower limb arthroplasty are of working age. This study aims to identify when patients return to work (RTW) and if they return to normal hours and duties, and to identify which factors influence postoperative RTW. The hypothesis is that there is no difference in time of RTW between the different types of surgery, and no difference in time of RTW based on the physical demands of the job.Materials and methodsConsecutive patients aged < 65 years who had undergone unilateral primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or medial unicompartmental knee arthroplasty (UKA) from 2015 to 2017 were sent a questionnaire. Quantitative questions explored timing and nature of RTW, and qualitative questions explored factors influencing timing of RTW.ResultsThere were 116 patients (64 male, 52 female) with an average age of 56 years. Thirty-one patients were self-employed and 85 were employees. Of these patients, 58 had undergone THA, 31 had undergone TKA, and 27 had undergone UKA. One hundred and six (91%) patients returned to work. Patients returned to work after (mean) 6.4 weeks (THA), 7.7 weeks (TKA), and 5.9 weeks (UKA). Time of RTW was not significantly influenced by type of surgery (p = 0.18) (ns). There was a non-significant correlation between physical demands of the work versus time of RTW (p = 0.28) (ns). There was a significantly earlier time of RTW if flexible working conditions were resumed (p = 0.003). Active recovery, motivation, necessity and job flexibility enabled RTW. The physical effects of surgery, medical restrictions and work factors impeded RTW.ConclusionThe time of RTW was not significantly influenced by the type of operation or by the physical demands of the job. Patients returned to work 5.9–7.7 weeks after hip/knee arthroplasty. Rehabilitation, desire, and necessity promoted RTW. Pain, fatigue and medical restrictions impeded RTW.Level of evidence3.

The Efficacy and Safety of Two Low-Dose Peri-Operative Dexamethasone in Total Hip Arthroplasty: A Single-Center Randomized Controlled Trial

“…In this study, ICFS was used to assess fatigue. The results showed that the postoperative ICFS score of dexa group was (69.38±8.65), and was signi cantly lower than that of the placebo group [(78.94±10.34)], and the difference was statistically signi cant between the two groups (P=0.00), which was consistent with the ndings of McGonagle [20] and Whibley [21] .In addition, Lei et al [5] also supported our results.…”

“…In our study, further analysis found that postoperative pain, nausea and fatigue may further increase patients' fear of discharge. Thus, it may prolong the hospital stay, which is consistent with the results of PEI et al [16] and McGonagle et al [20] , and it also indirectly con rms the systematic review of Whibley et al [21] .…”

“…Postoperative fatigue of THA is a common clinical symptom, which often leads to early recovery delay and affects patients' initiative in rehabilitation [20] .Through Meta analysis of the relationship among pain, sleep and fatigue, Whibley, et al [21] pointed out that the three factors in uenced each other and interacted with each other. It can be a virtuous circle established to promote early recovery of patients and improve hospitalization satisfaction if each factor is positively controlled.…”

High Rate of Full Duty Return to Work After Hip Arthroscopy for Femoroacetabular Impingement Syndrome in Workers Who Are Not on Workers’ Compensation

“…RTW was assessed using a standard patient survey. 28 Patients were first asked whether they were involved in paid employment within the 3-month period before surgery. If patients responded “yes,” they were instructed to submit the remainder of the survey.…”

Return to Work after Primary Total Knee Arthroplasty under the Age of 65 Years: A Systematic Review

“…Six studies found significant correlation while applying multivariate analysis. [11][12][13][14]18,19 Four studies did not perform any statistics but mentioned preferences or influencing factors reported by patients to be influencing their RTW. 9,10,16,17 Factors shown to be correlated with RTW by multivariate analysis were the physical nature of employment (p ¼ 0.03, 14 0.012, 11 and <0.0001 12,18 ), preoperative absence from work (p < 0.0001 18 and0.001 19 ), flexible work conditions Return to Work after Primary TKA at below 65 Years Van Leemput et al…”