Two-year recovery courses of physical and mental impairments, activity limitations, and participation restrictions after total knee arthroplasty among working-age patients

Hylkema, Tjerk H; Brouwer, Sandra; Stewart, Roy E.; Beveren, Jan van; Rijk, Paul C.; Brouwer, Reinoud W; Bulstra, Sjoerd K.; Kuijer, Paul; Stevens, Martin

doi:10.1080/09638288.2020.1766583

Cited by 25 publications

(22 citation statements)

References 38 publications

(50 reference statements)

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“…About two of every ten working-age patients are dissatisfied with their work ability due to their knee arthroplasty ( 13 ). The majority of workers return to their original or other work only after six months ( 13 , 14 ), and about three of every ten patients do not return to their original or other work after a year ( 13 , 15 ). Especially performance of knee-demanding activities like kneeling, crouching and clambering does not improve after surgery ( 16 ).…”

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confidence: 99%

Prevention at work needed to curb the worldwide strong increase in knee replacement surgery for working-age osteoarthritis patients

Kuijer¹,

Burdorf²

2020

Scand J Work Environ Health

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Prevention at work needed to curb the worldwide strong increase in knee replacement surgery for working-age osteoarthritis patients In the upcoming decades, hospitals and clinics around the world face a steep rise in demand from patients seeking knee replacement surgery. An absolute increase in knee replacement surgery of 297%-to 57 893 procedures-is forecasted in The Netherlands between 2005 and 2030 (1). The situation is similar in many countries: Sweden, 163% to 21 700 (2013-2030) (2); Italy, 45% to about 100 000 (2017-2050) (3), the UK, 916% to about 1.2 million (2015-2035) (4); Australia, 276% to 65 569 (2013-2030) (5); and the USA, 673% to 3.48 million (2005-2030) (6). No projections are available for Asia, however, similar growth percentages have already been seen in Japan of 373% (2007-2014) (7) and Korea (407%, 2001-2010) (8). Knee replacement surgery or arthroplasty is the final treatment option for patients suffering from knee osteoarthritis (OA). These increasing numbers are alarming, not only due to the extreme high demands on healthcare provision and budgets, but also for the unforeseen impact on work participation. There is a lack of awareness how work might play a significant role in reducing the steep rise in replacement surgery for knee OA across the world. Unforeseen impact on work The largest increase in primary surgery demands is not among the classic knee arthroplasty population of patients aged 70 years and older, but among patients of working age (1-4, 9). For instance, Germany-one of the leading countries in the prevalence of knee arthroplasty-foresees the highest increase in patients aged 50-65 years until 2050 (10), and in a similar study using the same database even among patients aged 40-49 years until 2040 (11). In several countries, the current proportion of knee arthroplasty patients under 65 years is already substantial at 30-40%. It is expected in 2030 that the USA will be the first country where the majority of these patients will be younger than 65 years (6), followed by the UK in 2035 (4). This increase in surgery and shift towards younger age groups can largely be explained by good clinical and cost-effective long-term outcomes, no clear threshold for surgery, and the rising number of younger and more demanding knee OA patients (9). Originally, knee arthroplasty was mainly aimed at reducing pain, improving knee function and thereby enhancing the performance of activities of daily life in the patient population aged 70 years and older. The current success was totally unforeseen by LG Shiers, the founding father of knee arthroplasty (12). In 1954, he concluded: "… few surgeons will ever see 50 patients requiring arthroplasty, let alone operate on them, even in five years". Nowadays, specialized orthopedic surgeons perform this procedure several times per day. Despite the good clinical outcomes, return to work is not that favorable after surgery. About two of every ten working-age patients are dissatisfied with their work ability due to their knee arthroplasty (13). The majority...

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Prevention at work needed to curb the worldwide strong increase in knee replacement surgery for working-age osteoarthritis patients

Kuijer¹,

Burdorf²

2020

Scand J Work Environ Health

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“…The ICF core set could provide information regarding the subspecialties or professions that should be combined for comprehensive post TKA rehabilitation interventions. Despite the post TKA pain relief, patients may continue to present muscle atrophy and ROM limitation, which limit daily living activities such as walking, climbing stairs, squatting and exercise [19]. Traditional rehabilitation for patients receiving TKA focuses on regaining ROM and strength, which were involved in physical functions.…”

Section: Discussionmentioning

confidence: 99%

“…[20] The core set for patients receiving TKA principally involved physical function categories, which was compatible with our findings. We identified 13 categories of physical function as the Despite the post TKA pain relief, patients may continue to present muscle atrophy and ROM limitation, which limit daily living activities such as walking, climbing stairs, squatting and exercise [19]. Traditional rehabilitation for patients receiving TKA focuses on regaining ROM and strength, which were involved in physical functions [20].…”

Section: Discussionmentioning

confidence: 99%

“…Despite the post TKA pain relief, patients may continue to present muscle atrophy and ROM limitation, which limit daily living activities such as walking, climbing stairs, squatting and exercise [ 19 ]. Traditional rehabilitation for patients receiving TKA focuses on regaining ROM and strength, which were involved in physical functions [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Development International Classification of Functioning, Disability and Health Core Set for Post Total Knee Replacement Rehabilitation Program: Delphi-Based Consensus Study in Taiwan

Huang

Chen

Escorpizo

et al. 2021

IJERPH

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Osteoarthritis is one of the leading causes of disability. Total knee arthroplasty (TKA) is a surgical intervention for patients with severe osteoarthritis. Post TKA rehabilitation is crucial for improving patient’s quality of life. However, traditional rehabilitation has only focused on physical function; a systemic analysis of other dimensions such as social participation and environmental factors of post TKA rehabilitation is lacking. The aim of this study was to develop a core set from the International Classification of Functioning, Disability and Health (ICF) to create a comprehensive rehabilitation program for patients with osteoarthritis post TKA. Before the Delphi-based consensus process, a literature review process was performed for related ICF categories selection. We used a three-round Delphi-based consensus among 20 physical therapists with orthopedic rehabilitation expertise in a university-based hospital. A five-point Likert scale was used to rate the importance of each item. The consensus of ratings was analyzed using Spearman’s rho and semi-interquartile range indices. The ICF core set for post TKA rehabilitation was determined based on a high level of consensus and a mean score of ≥4.0 in the third Delphi-based consensus round. The ICF core set comprised 32 categories, with 13 regarding body function, four regarding body structures, nine regarding activities and participation, four regarding environmental factors, and two regarding personal factors. Our ICF core set for post TKA rehabilitation can provide information on effective rehabilitation strategies and goal setting for patients post TKA. However, further validation and feasibility assessments are warranted.

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“…A prospective multicenter survey study was conducted among patients who underwent TKA or THA for primary OA. This study was part of the "Work participation In Patients with Osteoarthritis" cohort (WIPO, Trial-ID NTR3497) [32][33][34]. Patients were recruited between March 2012 and July 2014 at the orthopedic departments of four Dutch medical centers: University Medical Center Groningen (tertiary university hospital), Martini Hospital Groningen (large teaching hospital), Medical Center Leeuwarden (large teaching hospital) and Röpcke-Zweers Hospital Hardenberg (general hospital), all in the northern Netherlands.…”

Section: Design and Proceduresmentioning

confidence: 99%

Psychosocial Working Conditions Play an Important Role in the Return-to-Work Process After Total Knee and Hip Arthroplasty

et al. 2021

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Purpose Both personal and work-related factors affect return to work (RTW) after total knee arthroplasty (TKA) and total hip arthroplasty (THA). Little is known about work-related factors associated with the recovery process. This study aimed to determine which work-related factors are associated with time to RTW for both TKA and THA patients. Methods A prospective multicenter survey study was conducted that included patients aged 18–63, had a paid job and were scheduled to undergo primary TKA/THA. Surveys were completed preoperatively, 6 weeks, and 3, 6, and 12 months postoperatively, and included four domains of work-related factors: work characteristics, physical working conditions, psychosocial working conditions and work adjustments. Control variables included age, sex, education, and comorbidity. Time to RTW was defined as days from surgery until RTW. Multivariate linear regression analyses were conducted separately for TKA/THA patients. Results Enrolled were 246 patients (n = 146 TKA, n = 100 THA, median age 56 years, 57% female). Median time to RTW was 79 days (IQR 52.0–146.0). Mainly physical tasks (TKA: B 58.2, 95%CI 9.5–106.8; THA: B 52.1, 95%CI 14.1–90.2) and a combination of physical and mental tasks (TKA: B 50.2, 95%CI 6.4–94.0; THA B 54.0, 95%CI 24.2–83.7) were associated with longer time to RTW after both TKA and THA. More possibilities for personal job development (B − 12.8, 95%CI − 25.3–0.4) and more work recognition (B − 13.2, 95%CI − 25.5 to − 0.9) were significantly associated with shorter time to RTW after TKA. Higher quality of supervisor leadership (B − 14.1, 95%CI − 22.2 to − 6.0) was significantly associated with shorter time to RTW after THA. Conclusion The findings of this study stress the importance of psychosocial working conditions, besides type of job tasks, in RTW after TKA/THA. Further research on work-related factors is needed, as arthroplasty is being performed on an increasingly younger population of knee and hip OA patients for whom participating in work is of critical importance.

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Two-year recovery courses of physical and mental impairments, activity limitations, and participation restrictions after total knee arthroplasty among working-age patients

Abstract: Stevens (2020): Twoyear recovery courses of physical and mental impairments, activity limitations, and participation restrictions after total knee arthroplasty among working-age patients, Disability and Rehabilitation,

Cited by 25 publications

References 38 publications

Prevention at work needed to curb the worldwide strong increase in knee replacement surgery for working-age osteoarthritis patients

Prevention at work needed to curb the worldwide strong increase in knee replacement surgery for working-age osteoarthritis patients

Development International Classification of Functioning, Disability and Health Core Set for Post Total Knee Replacement Rehabilitation Program: Delphi-Based Consensus Study in Taiwan

Psychosocial Working Conditions Play an Important Role in the Return-to-Work Process After Total Knee and Hip Arthroplasty

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