Preoperative Predictors of Returning to Work Following Primary Total Knee Arthroplasty

Abstract

Although the physical demands of a patient's job have a moderate influence on the patient's ability to return to work following a primary total knee arthroplasty, the patient's characteristics, particularly motivation, play a more important role.

Do Patients Return to Work After Total Knee Arthroplasty?

“…These recovery periods are consistent with the general recommendations of the participating surgery centers. Our overall average of time of 9 weeks off work for recovery after TKA is the same as that reported in another American study involving 162 patients undergoing TKA, all of whom were working before surgery and followed prospectively for 6 months after surgery [17]. The percentage of patients in our study who required restrictions after surgery (19%) was similar to those requiring restrictions before TKA (18%).…”

“…Access to affordable health insurance for many patients is a benefit of employment in the United States and many other countries. In one US study of patients between the ages of 18 and 69 years undergoing TKA, 77% were receiving health insurance through their employer [17]. Although TKA is one of the most commonly and increasingly performed surgical procedures in the world, there is limited information for younger, high-demand patients in regard to return to work ( Table 4).…”

“…Although TKA is one of the most commonly and increasingly performed surgical procedures in the world, there is limited information for younger, high-demand patients in regard to return to work ( Table 4). The existing published studies on return to work after TKA are limited by several factors: (1) there is a wide range in expected recovery time after knee arthroplasty in published studies ranging from 4 to 9 weeks in three US studies [9,17,18] to as high as 12 months in one study [2]; (2) the patient cohorts were small (\ 120 TKAs) [2,4,9,10]; (3) the average patient age was older than 65 years [3,13,18,19]; (4) the study included low-demand patients [3,4,13,18,19]; (5) the study was reported in the literature more than 10 years ago [4,13,19]; and (6) the study was not designed specifically to analyze return to work [3,9,19]. The purpose of this multicenter study was to determine whether young patients who were working before undergoing primary TKA are able to return to work postoperatively and to determine whether the patient's preoperative job physical demand category has an effect on ability to return to work.…”

Determinants of return to work 12 months after total hip and knee arthroplasty

“…5,7 In our analysis, self-employment was also found to be associated with partial or no return to work whereas it was associated with a faster return to work in previous research. 16 It should be noted, however, that, in that study, the speed of return to work was the outcome, regardless the number of working hours. Our finding may be related to the observation that self-employed patients in all likelihood work more hours than wage earners and above the average for fulltime workers (approximately 36-40 hours per week), 17 yielding a larger potential for productivity loss.…”

The Role of Emotional Health in Functional Outcomes After Orthopaedic Surgery: Extending the Biopsychosocial Model to Orthopaedics

“…Of interest, a recent study found that the physical demands of a patient's job had a moderate influence on the patient's ability to return to work following a primary total knee arthroplasty. However, the authors noted that certain characteristics of the patient, such as a higher preoperative mental composite summary score on the Medical Outcomes Study 12-Item Short-Form Health Inventory Survey (SF-12) and a higher level of motivation (sense of urgency to return), increased the likelihood of return to work 39 . Traditionally, orthopaedists focus on optimal implant material, surgical technique, and postoperative rehabilitation to ensure optimal surgical outcome after total knee replacement.…”