Patients return to work sooner after unicompartmental knee arthroplasty than after total knee arthroplasty

Abstract

Purpose It is not yet known if unicompartmental knee arthroplasty (UKA) patients are more likely to return to work sooner or have improved ability to work (i.e., workability) than total knee arthroplasty (TKA) patients. The following questions were addressed: patients were assessed to determine: (1) whether they returned to work sooner following UKA compared to TKA; (2) whether UKA patients had better WORQ function scores compared to TKA patients; and (3) if UKA patients have higher workability scores and greater satisfaction regarding workability than TKA patients. Methods A multicenter retrospective cohort study was performed that included patients at least 2 years after having undergone either UKA or TKA surgery and on the condition that patients had been in work in the 2 years prior to surgery. Time period between stopping work and returning to work was assessed; the WORQ scores (0 = worst-100 = best) and the Work Ability Index (WAI = 0-10) and reported satisfaction with work ability. Results UKA patients (n = 157, median 60 years, 51% male) were compared to TKA patients (n = 167, median 60 years, 49% male) (n.s.). Of the 157 UKA patients, 115 (73%) returned to work within 2 years compared to 121 (72%) of TKA patients (n.s.). More UKA patients return to work within 3 months (73% versus 48%) (p < 0.01). WORQ scores improved similarly in both groups. The WAI was also comparable between the groups. Dissatisfaction with workability was comparable (UKA 15% versus TKA 18% (n.s.). Conclusion TKA and UKA patients have similar WORQ, WAI, and satisfaction scores. However, in this study population, UKA patients to return to work after surgery significantly sooner than TKA patients, which improves their quality of life and allows them to participate actively in society. This information can help health care providers and patients weigh-up the pros and cons and choose the best treatment and timing for patients in the working population. Level of evidence III. Knee Surgery, Sports Traumatology, ArthroscopyPublisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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

“…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 ).…”

Lifetime revision risk for medial unicompartmental knee replacement is lower than expected

“…As was expected, higher rates were found in younger patients. The youngest modelled patient age was 55, and patients of this age were found to have a lifetime revision risk of 15% (CI [12][13][14][15][16][17][18][19]. This reduced to a lifetime risk of 4% (CI 3-5) for those of 85 years of age at operation.…”

“…The evidence from large matched studies is that UKR provides a faster recovery [ 7 ], lower morbidity and mortality [ 19 ], return to work quicker [ 18 ], better function and better satisfaction [ 20 , 38 , 41 ] than TKR. However, UKR are reported in national registries as having a higher revision rate [ 24 – 27 ].…”

Development of a Personalized m/eHealth Algorithm for the Resumption of Activities of Daily Life Including Work and Sport after Total and Unicompartmental Knee Arthroplasty: A Multidisciplinary Delphi Study

“…The PROMIS-PF examines physical function and includes 121 activities covering simple everyday activities, as well as more complex activities that require a combination of skills [28]. The WORQ contains 13 activities that are often performed at the workplace [29,30]. Based on these three questionnaires and the literature identified (mentioned under Section 2.3), during a meeting the research team selected activities that they considered relevant for knee arthroplasty rehabilitation.…”