Abstract
Purpose This study compared the preoperative levels and postoperative recovery courses of physical and mental impairments, activity limitations and participation restrictions of working-age patients who return to work (RTW) by 3, 6 or 12 months after total knee arthroplasty (TKA). Methods A prospective survey study including TKA patients (aged < 65) (n = 146) who returned to work (RdTW) in the first postoperative year. Three groups were compared: those who returned by 3 (n = 35), 6 (n = 40) or 12 (n = 29) months. Surveys were completed preoperatively and at 6 weeks and 3, 6 and 12 months postoperatively. Outcomes represented domains of the International Classification of Functioning, i.e. physical impairments (pain, stiffness, vitality), mental impairments (mental health and depressive symptoms), activity limitations (physical functioning) and participation restrictions (social and work functioning). Results Preoperative knee-specific pain and physical functioning levels were better among patients who RdTW by 3 months, compared to those who returned by 12 months. Patients who RdTW by 3 months experienced significantly better recovery from physical impairments than those who returned by 6 months (on general pain) or 12 months (on general and knee-specific pain and on stiffness). Patients returning by 3 months experienced significantly better recovery from activity limitations (on knee-specific physical functioning). Conclusions To optimize return to work outcome after TKA surgery, the focus should lie on physical impairments (general and knee-specific pain, stiffness) and activity limitations (knee-specific physical functioning) during recovery.
Highlights
Total knee arthroplasty (TKA) is considered to be an effective surgical treatment for end-stage knee osteoarthritis [1]
No significant differences between groups were found for the included sociodemographic variables of age, gender, body mass index (BMI), comorbidity, educational level, home situation, being the main breadwinner, type of employment or job type
Patients who returned by 3 months compared to those returning by 6 or 12 months reported better recovery courses from physical impairments in terms of general and knee-specific pain as well as stiffness
Summary
Total knee arthroplasty (TKA) is considered to be an effective surgical treatment for end-stage knee osteoarthritis [1]. The greatest increase in TKA is seen in patients aged 45–65, to further climb in future projections, while it is anticipated that by 2030 at least 60% of TKAs will be performed in the working-age population [5,6,7]. This trend coincides with delayed retirement, raising the number of working-age patients undergoing TKA surgery even further. While work is beneficial for physical and mental health, it is important for socioeconomic reasons [8]
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