Return to work following total knee arthroplasty: A multiple case study of stakeholder perspectives

Abstract

Objective: The study’s aim was to gain insights into factors influencing sustainable return to work following total knee arthroplasty (TKA). Design: A descriptive multiple-case design was used. A case was defined as a worker’s following TKA work disability situation. Settings: The cases came from public hospitals in urban and semi-urban areas in Quebec (Canada) and involved mostly non-work-related TKAs. Subjects: Workers had to be between 6 and 12 months post-TKA, have physical/manual jobs and currently employed. Their rehabilitation professionals and workplace representatives (employer and/or union) were also recruited, based on the work disability paradigm. Main measures: Semi-structured interviews, questionnaires on pain, physical work demands (workers only), and observation of the work activities of those workers back at work were used. Cases were compared and categorized for worker-perceived levels of difficulty in returning to or staying at work: little or no difficulty ( n = 8); some difficulty ( n = 5); not back at work due to excessive difficulty with their knee ( n = 4). Results: A total of 17 cases were constituted. In only one case, the worker benefitted from an interdisciplinary work rehabilitation approach. Results highlight the interplay among these factors: (1) the workers’ perceptions of their residual symptoms and ability to manage them, (2) the interaction between work adjustments and tools offered by the employers and the workers’ own strategies, and (3) perceptions of the workers’ physical capacities. Conclusion: Workers’ who face high levels of work demands/difficulties and who have limited access to work adjustments and tools should be referred for work rehabilitation.

Does Consulting an Occupational Medicine Specialist Decrease Time to Return to Work Among Total Knee Arthroplasty Patients? A 12-Month Prospective Multicenter Cohort Study

“…If that is true then it can be argued that patients with high expected WAS would be able to safely RTW early and on their own accord in contrast to patients with low expected WAS given their worse physical ability in relation to their physical job demands. Qualitative findings also support the hypothesis that patients' needs are partially based on having access to work adjustments and tools [13]. In line with these findings, patients in our study who have high expectations and do consult an OMS, might probably experience a lack of supportive interventions and for that reason consult an OMS.…”

“…Subsequently the OMS can advise and support the RTW process, for instance by advising adjustment of working hours, working tasks (modified duties) or workplace adaptations using ergonomic principles. Patients who have limited access to these kinds of work adjustments and have difficulty performing work-related knee-straining activities may also be referred by their OMS to work rehabilitation [ 13 ]. Moreover, an OMS is able to discuss and stimulate the sense of urgency to RTW given the value of work in life [ 14 ].…”

Patient perspectives of pain and function after knee replacement: a systematic review and meta-synthesis of qualitative studies

“…Return to function was inconsistent, individual and “trial and error.” 60 Participants adapted movements 16 , 65 because of persistent pain and reduced mobility, creating workarounds. 77 Medication use was also trialled by individuals, outside of clinician recommendation, such as using complementary medications, reducing doses, or stopping medication.…”

“…Twenty-eight studies 5,9,10,12,16,23,26,32,35,36,40,41 from 11 countries, 45,[47][48][49]51,57,60 spanning 4 regions, [64][65][66][67]69,74,77,78,82 were included (Table 2). The oldest study was published in 2004 and the most recent in 2020.…”

Оцінка Точності Вирівнювання Механічної Вісі Нижньої Кінцівки За Допомогою Індивідуального Інструменту При Ендопротезуванні Колінного Суглоба

“…За останні роки згідно статистиці до 20,0 % сучасних пацієнтів вважають, що їхні очікування не були досягнуті [3,5,14]. Однією із значущих проблем, що викликає безліч наслідків, є невідповідність позиції компонентів ендопротеза індивідуальній анатомії колінного суглоба, яка, за даними різних авторів, становить від 20,0 до 40,0 % [2,3,7,9,13]. На сьогоднішній день цю проблему намагаються вирішити за допомогою різних методів, таких як індивідуальний інструмент для встановлення імплантатів та різноманітні системи комп'ютерної навігації.…”