Abstract

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.

Highlights

  • Osteoarthritis (OA) is one of the most common reasons for chronic musculoskeletal pain [1]

  • We found that besides type of job tasks, the key factors were psychosocial working conditions for both groups, with some additional differences between Total knee arthroplasty (TKA) and total hip arthroplasty (THA) patients in the type of psychosocial working conditions associated with time to return to work (RTW) within 12 months of surgery

  • We found that possibilities for personal job development, more work recognition and high quality of supervisor leadership resulted in a significant shorter time to RTW

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Summary

Introduction

Osteoarthritis (OA) is one of the most common reasons for chronic musculoskeletal pain [1]. It is a highly prevalent chronic joint disease that affects about one in eight adults worldwide [2]. Among working-age individuals OA is one of the leading causes of disability [3], and is strongly associated with reduced productivity among working individuals [4]. Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are effective procedures to reduce pain and improve. The greatest spike in TKA and THA is seen in patients of working age. The number of TKA and THA patients below age 65 already tripled between 1995 and 2003 in the Netherlands, and this number is expected to rise further [10]

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