Background and purpose:
An increasing amount of people undergoing total knee or hip arthroplasty surgery is still of working age at the time this procedure is performed. However, there is limited information in the literature about returning to work after arthroplasty surgery. Therefore, the purpose of this study was to get more insight into the influence of self-reported preoperative physical functioning on the period of time until return to work after total hip or knee arthroplasty surgery.
Subjects and methods:
A prospective multi-center cohort study is conducted at University Medical Center Groningen, Martini Hospital Groningen, Medical Center Leeuwarden and Röpcke-Zweers Hospital Hardenberg. In this sub study the data that have been collected before the 9th of April 2013 were used in the analyses. 81 patients scheduled for total knee or hip arthroplasty surgery filled in a questionnaire preoperative and postoperative after six weeks and three months. Self-reported physical functioning was measured with the WOMAC questionnaire. In addition, the period to return to work was asked for in the questionnaire. A multivariate cox-regression analysis was used to examine the predictive value of preoperative self-reported physical functioning as well as the change in self-reported physical functioning between preoperative and three months postoperative on the time to return to work. Age, gender, education level, comorbidity, depressive complaints and BMI were included as co-variables in the analyses.
Results:
Three months postoperative 63% of the patients undergoing surgery returned to work. The mean period of time until return to work was 58 days (standard deviation 25.06). The WOMAC-score (self-reported physical functioning) three months postoperative was on average 30.03 points (SD 21.17) higher in comparison with the preoperative score. Multivariate cox-regression analyses showed that preoperative self-reported physical functioning had no predictive value for the period of time until reintegration (hazard ratio 1.00, p=0.97), adjusted for BMI (0.96, p=0.16) and education level (HR 2.26, p<0.05). Improvement in self-reported physical functioning between preoperative and three months postoperative was significantly associated with a shorter period of time until return to work (HR 1.03, p<0.05). This association was adjusted for preoperative self-reported physical functioning (HR 1.02, p=0.06), BMI (HR 0.94, p<0.05) and education level (HR 2.01, p=0.09).
Discussion and conclusion:
63% of the patients undergoing knee or hip arthroplasty surgery have returned to work after three months. It does not seem possible to use the preoperative self-reported physical functioning to predict the period of time until a patient will be able to return to work after surgery. However, improvement in self-reported physical functioning is significantly associated with a shorter period of time until return to work. More extensive research with more patients is necessary to confirm our findings.