Return to work after total hip or total knee arthroplasty

Osteoarthritis is expected to become the most prevalent chronic disorder in the Netherlands by 2040, with its incidence rising rapidly. Total hip or knee arthroplasty (THA/TKA) is considered the most cost-effective treatment for advanced hip or knee osteoarthritis, and its demand is increasing. Notably, more individuals of working age are opting for these procedures, leading to a shift in rehabilitation needs. We investigated the role of system-related factors (i.e. healthcare- and social security systems, clinical guidelines) and work-related factors (i.e. workplace characteristics, physical- and psychosocial working conditions, and work adjustments) on return to work, and factors associated with fulfilment of patient expectations towards paid employment for the growing group of working-age THA and TKA patients. The findings suggest that there are opportunities to enhance the current attention given to work, highlighting a lack of collaboration among healthcare professionals (orthopaedic surgeons and occupational physicians) and scarcity of guidelines. The thesis reveals that psychosocial working conditions (e.g. possibilities for personal job development, work recognition and quality of supervisor leadership) and expectations, not just physical working conditions (e.g. physical job tasks), play a crucial role in return to work. The insights from this research may improve care for workers undergoing a THA/TKA, advocating for a work-oriented approach. One way to achieve this, would be by incorporating the topic into multidisciplinary guidelines and healthcare provider education. The challenge ahead is to identify and implement multidisciplinary intervention strategies for sustainable RTW, fostering a well-connected care chain

Return to work after total hip or total knee arthroplasty

Osteoarthritis is expected to become the most prevalent chronic disorder in the Netherlands by 2040, with its incidence rising rapidly. Total hip or knee arthroplasty (THA/TKA) is considered the most cost-effective treatment for advanced hip or knee osteoarthritis, and its demand is increasing. Notably, more individuals of working age are opting for these procedures, leading to a shift in rehabilitation needs. We investigated the role of system-related factors (i.e. healthcare- and social security systems, clinical guidelines) and work-related factors (i.e. workplace characteristics, physical- and psychosocial working conditions, and work adjustments) on return to work, and factors associated with fulfilment of patient expectations towards paid employment for the growing group of working-age THA and TKA patients. The findings suggest that there are opportunities to enhance the current attention given to work, highlighting a lack of collaboration among healthcare professionals (orthopaedic surgeons and occupational physicians) and scarcity of guidelines. The thesis reveals that psychosocial working conditions (e.g. possibilities for personal job development, work recognition and quality of supervisor leadership) and expectations, not just physical working conditions (e.g. physical job tasks), play a crucial role in return to work. The insights from this research may improve care for workers undergoing a THA/TKA, advocating for a work-oriented approach. One way to achieve this, would be by incorporating the topic into multidisciplinary guidelines and healthcare provider education. The challenge ahead is to identify and implement multidisciplinary intervention strategies for sustainable RTW, fostering a well-connected care chain

Return to work after total hip or total knee arthroplasty

Osteoarthritis is expected to become the most prevalent chronic disorder in the Netherlands by 2040, with its incidence rising rapidly. Total hip or knee arthroplasty (THA/TKA) is considered the most cost-effective treatment for advanced hip or knee osteoarthritis, and its demand is increasing. Notably, more individuals of working age are opting for these procedures, leading to a shift in rehabilitation needs. We investigated the role of system-related factors (i.e. healthcare- and social security systems, clinical guidelines) and work-related factors (i.e. workplace characteristics, physical- and psychosocial working conditions, and work adjustments) on return to work, and factors associated with fulfilment of patient expectations towards paid employment for the growing group of working-age THA and TKA patients. The findings suggest that there are opportunities to enhance the current attention given to work, highlighting a lack of collaboration among healthcare professionals (orthopaedic surgeons and occupational physicians) and scarcity of guidelines. The thesis reveals that psychosocial working conditions (e.g. possibilities for personal job development, work recognition and quality of supervisor leadership) and expectations, not just physical working conditions (e.g. physical job tasks), play a crucial role in return to work. The insights from this research may improve care for workers undergoing a THA/TKA, advocating for a work-oriented approach. One way to achieve this, would be by incorporating the topic into multidisciplinary guidelines and healthcare provider education. The challenge ahead is to identify and implement multidisciplinary intervention strategies for sustainable RTW, fostering a well-connected care chain

Return to work after total hip or total knee arthroplasty

Osteoarthritis is expected to become the most prevalent chronic disorder in the Netherlands by 2040, with its incidence rising rapidly. Total hip or knee arthroplasty (THA/TKA) is considered the most cost-effective treatment for advanced hip or knee osteoarthritis, and its demand is increasing. Notably, more individuals of working age are opting for these procedures, leading to a shift in rehabilitation needs. We investigated the role of system-related factors (i.e. healthcare- and social security systems, clinical guidelines) and work-related factors (i.e. workplace characteristics, physical- and psychosocial working conditions, and work adjustments) on return to work, and factors associated with fulfilment of patient expectations towards paid employment for the growing group of working-age THA and TKA patients. The findings suggest that there are opportunities to enhance the current attention given to work, highlighting a lack of collaboration among healthcare professionals (orthopaedic surgeons and occupational physicians) and scarcity of guidelines. The thesis reveals that psychosocial working conditions (e.g. possibilities for personal job development, work recognition and quality of supervisor leadership) and expectations, not just physical working conditions (e.g. physical job tasks), play a crucial role in return to work. The insights from this research may improve care for workers undergoing a THA/TKA, advocating for a work-oriented approach. One way to achieve this, would be by incorporating the topic into multidisciplinary guidelines and healthcare provider education. The challenge ahead is to identify and implement multidisciplinary intervention strategies for sustainable RTW, fostering a well-connected care chain

Influence of social support on return to work after total hip or total knee arthroplasty:a prospective multicentre cohort study

OBJECTIVES: There is strong evidence that social support is an important determinant of return to work (RTW). Little is known about the role of social support in RTW after total hip or knee arthroplasty (THA/TKA). Objective was to examine the influence of preoperative and postoperative perceived social support on RTW status 6 months postoperatively. DESIGN: A prospective multicentre cohort study was conducted. SETTING: Orthopaedic departments of four Dutch medical centres; a tertiary university hospital, two large teaching hospitals and a general hospital. PARTICIPANTS: Patients planned to undergo THA/TKA, aged 18-63 and employed preoperatively were included. MAIN OUTCOME MEASURES: Questionnaires were filled out preoperatively and 3 and 6 months postoperatively and included questions to assess patients' perceived social support targeting three sources of social support: from home (friends, family), from work (coworkers, supervisors) and from healthcare (occupational physician, general practitioner, other caregivers). Control variables included age, gender, education, type of arthroplasty and comorbidities. RTW was defined as having fully returned to work 6 months postoperatively. Univariate and multivariate logistic regression analyses were conducted. RESULTS: Enrolled were 190 patients (n=77 THA, n=113 TKA, median age was 56 years, 56% women). The majority returned to work (64%). Preoperatively, social support from the occupational physician was associated with RTW (OR 2.53, 95% CI 1.15 to 5.54). Postoperatively, social support from the occupational physician (OR 3.04, 95% CI 1.43 to 6.47) and the supervisor (OR 2.56, 95% CI 1.08 to 6.06) was associated with RTW. CONCLUSIONS: This study underscores the importance of work-related social support originating from the occupational physician and supervisor in facilitating RTW after primary THA/TKA, both preoperatively and postoperatively. Further research is needed to confirm our results and to understand the facilitating role of social support in RTW, as arthroplasty is being performed on a younger population for whom work participation is critical

Psychosocial Working Conditions Play an Important Role in the Return-to-Work Process After Total Knee and Hip Arthroplasty

Purpose Both personal and work-related factors affect return to work (RTW) after total knee arthroplasty (TKA) and total hip arthroplasty (THA). Little is known about work-related factors associated with the recovery process. This study aimed to determine which work-related factors are associated with time to RTW for both TKA and THA patients. Methods A prospective multicenter survey study was conducted that included patients aged 18-63, had a paid job and were scheduled to undergo primary TKA/THA. Surveys were completed preoperatively, 6 weeks, and 3, 6, and 12 months postoperatively, and included four domains of work-related factors: work characteristics, physical working conditions, psychosocial working conditions and work adjustments. Control variables included age, sex, education, and comorbidity. Time to RTW was defined as days from surgery until RTW. Multivariate linear regression analyses were conducted separately for TKA/THA patients. Results Enrolled were 246 patients (n = 146 TKA, n = 100 THA, median age 56 years, 57% female). Median time to RTW was 79 days (IQR 52.0-146.0). Mainly physical tasks (TKA: B 58.2, 95%CI 9.5-106.8; THA: B 52.1, 95%CI 14.1-90.2) and a combination of physical and mental tasks (TKA: B 50.2, 95%CI 6.4-94.0; THA B 54.0, 95%CI 24.2-83.7) were associated with longer time to RTW after both TKA and THA. More possibilities for personal job development (B - 12.8, 95%CI - 25.3-0.4) and more work recognition (B - 13.2, 95%CI - 25.5 to - 0.9) were significantly associated with shorter time to RTW after TKA. Higher quality of supervisor leadership (B - 14.1, 95%CI - 22.2 to - 6.0) was significantly associated with shorter time to RTW after THA. Conclusion The findings of this study stress the importance of psychosocial working conditions, besides type of job tasks, in RTW after TKA/THA. Further research on work-related factors is needed, as arthroplasty is being performed on an increasingly younger population of knee and hip OA patients for whom participating in work is of critical importance