Not Physical Activity, but Patient Beliefs and Expectations are Associated With Return to Work After Total Knee Arthroplasty

Hoorntje, Alexander; Leichtenberg, Claudia S.; Koenraadt, Koen L. M.; Geenen, Rutger C. I. van; Kerkhoffs, Gino M. M. J.; Nelissen, Rob G H H; Vlieland, Thea Vliet; Kuijer, Paul

doi:10.1016/j.arth.2017.11.032

Cited by 30 publications

(30 citation statements)

References 29 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Preoperative sick leave appears to be a consistent prognostic factor for RTW. All studies that included preoperative sick leave in the analysis found lower RTW for patients who were absent from work preoperatively, which is in line with findings in patients undergoing knee arthroplasty [ 24 , 71 , 72 ]. Furthermore, a higher preoperative workload was associated with lower RTW in most studies.…”

Section: Discussionsupporting

confidence: 79%

The Effect of Total Hip Arthroplasty on Sports and Work Participation: A Systematic Review and Meta-Analysis

et al. 2018

Self Cite

View full text Add to dashboard Cite

BackgroundTotal hip arthroplasty (THA) is a successful procedure to treat end-stage hip osteoarthritis. The procedure is increasingly performed in adults of working age, who often wish to return to sports (RTS) and return to work (RTW). However, a systematic overview of the evidence on RTS and RTW after THA is lacking.ObjectivesOur aim was to systematically review (1) the extent to which patients RTS and RTW after THA, including (2) the time to RTS and RTW.MethodsWe searched MEDLINE and Embase from inception until October 2017. Two authors screened and extracted the data, including study information, patient demographics, rehabilitation protocols and pre- and postoperative sports and work participation. Methodological quality was assessed using the Newcastle–Ottawa scale. Data on pre- and postoperative sports and work participation were pooled using descriptive statistics.ResultsA total of 37 studies were included, of which seven were prospective studies and 30 were retrospective studies. Methodological quality was high in 11 studies, moderate in 16 studies, and low in ten studies. RTS was reported in 14 studies. Mean RTS was 104% to the pre-surgery level and 82% to the pre-symptomatic sports level. Time to RTS varied from 16 to 28 weeks. RTW was reported in 23 studies; the mean was 69%. Time to RTW varied from 1 to 17 weeks.ConclusionA great majority of patients RTS and RTW after THA within a timeframe of 28 and 17 weeks, respectively. For the increasingly younger THA population, this is valuable information that can be used in the preoperative shared decision-making process.Electronic supplementary materialThe online version of this article (10.1007/s40279-018-0924-2) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 79%

The Effect of Total Hip Arthroplasty on Sports and Work Participation: A Systematic Review and Meta-Analysis

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…Also, one could speculate that the activities-of-daily-living and leisure-time goals were not ambitious enough, given the previously reported low metabolic equivalent of task values in our cohort 4 . Finally, it is known that patients’ perception that their knee symptoms are work-related is associated with worse results in terms of return to work after KA 33 . In our study, only in the intervention group, by formulating personal GAS goals, did patients specifically address their most important work-specific activity limitations caused by knee symptoms with their therapist.…”

Section: Discussionmentioning

confidence: 99%

Goal Attainment Scaling Rehabilitation Improves Satisfaction with Work Activities for Younger Working Patients After Knee Arthroplasty

Hoorntje

Waterval-Witjes

Koenraadt

et al. 2020

Journal of Bone and Joint Surgery

Self Cite

View full text Add to dashboard Cite

Background: Knee arthroplasty (KA) is increasingly performed in relatively young, active patients. This heterogeneous patient population often has high expectations, including work resumption and performance of knee-demanding leisure-time activities. Goal attainment scaling (GAS) may personalize rehabilitation by using patient-specific, activity-oriented rehabilitation goals. Since unmet expectations are a leading cause of dissatisfaction after KA, personalized rehabilitation may improve patient satisfaction. We hypothesized that, compared with standard rehabilitation, GAS-based rehabilitation would result in younger, active patients having higher satisfaction regarding activities after KA. Methods: We performed a single-center randomized controlled trial. Eligible patients were <65 years of age, working outside the home, and scheduled to undergo unicompartmental or total KA. The required sample size was 120 patients. Using GAS, patients developed personal activity goals with a physiotherapist preoperatively. These goals were used to monitor patients’ goal attainment and provide goal-specific feedback during postoperative outpatient rehabilitation. Standard rehabilitation consisted of regular outpatient physiotherapy visits. The primary outcome measures were visual analogue scale (VAS) scores (scale of 0 to 100) for satisfaction regarding activities of daily living and work and leisure-time activities 1 year postoperatively, which were analyzed using generalized estimating equation models. Results: Patient satisfaction with work activities was significantly higher in the GAS group (β = 10.7 points, 98% confidence interval [CI] = 2.0 to 19.4 points) than in the control group. Patient satisfaction with activities of daily living and leisure-time activities did not differ between groups. We found no differences in VAS satisfaction scores between unicompartmental KA and total KA. Conclusions: Personalized, goal-specific rehabilitation using GAS resulted in higher patient satisfaction with work activities, compared with standard rehabilitation, 1 year after KA. Level of Evidence: Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

show abstract

“…Return to work after TKA is influenced by several determinants including state of patient's general health and presence of comorbid diseases, psychosocial and motivational factors, rate of work-related knee demand, and possibility to make adjustments to work tasks. In addition, Hoorntje et al reported that also patient beliefs and preoperative expectations influence return to work after TKA [42]. Predictors of successful return to work after knee replacement have not been thoroughly studied.…”

Section: Discussionmentioning

confidence: 99%

Are patient-related pre-operative factors influencing return to work after total knee arthroplasty

et al. 2019

View full text Add to dashboard Cite

Background: Osteoarthritis is one of the leading causes of disability in working-age patients. The total number of working-age patients undergoing total-knee arthroplasty (TKA) is continuously increasing. The purpose of this study was to identify predictive factors related to general health, health risk behaviors and socioeconomic status influencing the rate of return to work after a TKA. Methods: Overall there were 151,901 patients included in the Finnish Public Sector (FPS) study. The response rate varied between 65 and 73% during the study period. We used Cox proportional hazard models to examine patient-related predictive factors that may influence the rate of return to work after TKA in a cohort of patients (n = 452; n = 362 female; mean age 56.4 years). Predictive factors were measured on average 3.6 years before the operation. Results: Of the patients, 87% returned to work within one year after TKA at a mean of 116 calendar days. In multivariate analysis, patients at sick-leave ≤30 days during the last year before surgery were 2.2 times (95% confidence interval 1.72-2.92) more likely to return to work compared with those with N30 days of sick-leave. Compared with patients in manual work, those in higher or lower level non-manual work showed a 2.6-fold (1.95-3.52) and 1.5-fold (1.15-1.92) increased probability of returning to work. Age, sex, health risk behaviors, obesity, physical comorbidities, common mental disorders, and other studied health-related factors were not associated with the rate of return to work. Conclusions: Non-manual job, good self-rated general health and preoperative sick leave ≤30 days are associated with a higher rate of return to work.

show abstract

Not Physical Activity, but Patient Beliefs and Expectations are Associated With Return to Work After Total Knee Arthroplasty

Abstract: No association between preoperative PA and RTW after TKA was found. Patient beliefs and preoperative expectations did influence RTW and should be addressed to further improve RTW after TKA.

Cited by 30 publications

References 29 publications

The Effect of Total Hip Arthroplasty on Sports and Work Participation: A Systematic Review and Meta-Analysis

The Effect of Total Hip Arthroplasty on Sports and Work Participation: A Systematic Review and Meta-Analysis

Goal Attainment Scaling Rehabilitation Improves Satisfaction with Work Activities for Younger Working Patients After Knee Arthroplasty

Are patient-related pre-operative factors influencing return to work after total knee arthroplasty

Contact Info

Product

Resources

About