Return to Work After Surgery For Trapeziometacarpal Joint Osteoarthritis in Relation to Occupational Hand Force Requirements

Abstract

This study evaluated the hypothesis that higher occupational hand force requirements are related to slower return to work (RTW) after surgery for trapeziometacarpal joint osteoarthritis. Patients treated surgically for trapeziometacarpal joint osteoarthritis from 2001 to 2017 were identified in the Danish National Patient Register. Sustainable RTW (sRTW) was defined as the first period of 4 consecutive weeks without health-related public transfer payments, according to the Danish National Register on Public Transfer Payments. Occupational codes from the Danish Employment Classification Module were linked to a hand-arm job exposure matrix to obtain occupational hand force requirements for each patient. Cox regression models were used to analyze time until sRTW in relation to hand force requirements with adjustment for age, sex, type of surgery, preoperative sick leave, and calendar year of surgery. The study included 2,090 patients. Within 104 weeks, 91% sustainably returned to work. The percentage of individuals in the subgroups that did not RTW was 8% of low-force- and medium-force-exposed patients and 14% of high-force-exposed patients. Medium and high occupational hand force requirements were associated with slower sRTW. The adjusted hazard ratio for sRTW was 0.84 (95% confidence interval, 0.74-0.95) for medium and 0.59 (95% confidence interval, 0.50-0.68) for high compared with low hand force requirements. Among patients who returned to work, patients with medium and high hand force requirements had median periods until sRTW of 16 and 18 weeks, respectively, compared with 10 weeks among patients with low hand force requirements. The prognosis regarding RTW after surgery for trapeziometacarpal joint osteoarthritis is generally good, but patients with higher occupational hand force requirements can expect slower RTW. Prognostic II.