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

2020 ◽  
pp. 026921552098431
Author(s):  
Marie-France Coutu ◽  
Nathaly Gaudreault ◽  
Marie-Eve Major ◽  
Iuliana Nastasia ◽  
Réjean Dumais ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Return To Work ◽  
Knee Arthroplasty ◽  
Work Disability ◽  
Public Hospitals ◽  
Physical Work ◽  
Work Demands ◽  
Work Rehabilitation ◽  
Multiple Case ◽  
Total Knee

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.

scholarly journals Are patient-related pre-operative factors influencing return to work after total knee arthroplasty

The Knee ◽  
2019 ◽  
Vol 26 (4) ◽  
pp. 853-860
Author(s):  
Petteri Lankinen ◽  
Raul Laasik ◽  
Mika Kivimäki ◽  
Ville Aalto ◽  
Mikhail Saltychev ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Return To Work ◽  
Knee Arthroplasty ◽  
Factors Influencing ◽  
Total Knee

scholarly journals Not Physical Activity, but Patient Beliefs and Expectations are Associated With Return to Work After Total Knee Arthroplasty

2018 ◽  
Vol 33 (4) ◽  
pp. 1094-1100 ◽  
Author(s):  
Alexander Hoorntje ◽  
Claudia S. Leichtenberg ◽  
Koen L.M. Koenraadt ◽  
Rutger C.I. van Geenen ◽  
Gino M.M.J. Kerkhoffs ◽  
...  
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Return To Work ◽  
Knee Arthroplasty ◽  
Patient Beliefs ◽  
Total Knee

Differences in time to return to work among patients undergoing simultaneous versus staged bilateral total knee arthroplasty

2021 ◽  
Vol 103-B (6 Supple A) ◽  
pp. 108-112
Author(s):  
Cynthia A. Kahlenberg ◽  
Ethan C. Krell ◽  
Thomas P. Sculco ◽  
Jeffrey N. Katz ◽  
Joseph T. Nguyen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Surgical Treatment ◽  
Return To Work ◽  
Knee Arthroplasty ◽  
Patient Reported Outcome ◽  
Simultaneous Group ◽  
Patient Reported ◽  
Total Knee ◽  
American Society ◽  
Simultaneous Bilateral Tka

Aims Many patients undergoing total knee arthroplasty (TKA) have severe osteoarthritis (OA) in both knees and may consider either simultaneous or staged bilateral TKA. The implications of simultaneous versus staged bilateral TKA for return to work are not well understood. We hypothesized that employed patients who underwent simultaneous bilateral TKA would have significantly fewer days missed from work compared with the sum of days missed from each operation for patients who underwent staged bilateral TKA. Methods The prospective arthroplasty registry at the Hospital for Special Surgery was used. Baseline characteristics and patient-reported outcome scores were evaluated. We used a linear regression model, adjusting for potential confounding variables including age, sex, preoperative BMI, and type of work (sedentary, moderate, high activity, or strenuous), to analyze time lost from work after simultaneous compared with staged bilateral TKA. Results We identified 152 employed patients who had undergone simultaneous bilateral TKA and 61 who had undergone staged bilateral TKA, and had completed the registry’s return to work questionnaire. The simultaneous group missed a mean of 46.2 days (SD 29.1) compared with the staged group who missed a mean total of 68.0 days of work (SD 46.1) when combining both operations. This difference was statistically significant (p < 0.001). In multivariate mixed regression analysis adjusted for age, sex, BMI, American Society of Anesthesiologists status, and type of work, the simultaneous group missed a mean of 16.9 (SD 5.7) fewer days of work compared with the staged group (95% confidence interval 5.8 to 28.1; p = 0.003). Conclusion Employed patients undergoing simultaneous bilateral TKA missed a mean of 17 fewer days of work as a result of their surgical treatment and rehabilitation compared with those undergoing staged bilateral TKA. This information may be useful to surgeons counselling employed patients with bilateral OA of the knee who are considering surgical treatment. Cite this article: Bone Joint J 2021;103-B(6 Supple A):108–112.

scholarly journals Total Knee Arthroplasty and the Unforeseen Impact on Return to Work: A Cross-Sectional Multicenter Survey

2014 ◽  
Vol 29 (6) ◽  
pp. 1163-1168 ◽  
Author(s):  
Arthur J. Kievit ◽  
Rutger C.I. van Geenen ◽  
P. Paul F.M. Kuijer ◽  
Thijs M.J. Pahlplatz ◽  
Leendert Blankevoort ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Return To Work ◽  
Knee Arthroplasty ◽  
Cross Sectional ◽  
Multicenter Survey ◽  
Total Knee

scholarly journals Do Patients Return to Work After Total Knee Arthroplasty?

2013 ◽  
Vol 472 (1) ◽  
pp. 138-146 ◽  
Author(s):  
Adolph V. Lombardi ◽  
Ryan M. Nunley ◽  
Keith R. Berend ◽  
Erin L. Ruh ◽  
John C. Clohisy ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Return To Work ◽  
Knee Arthroplasty ◽  
Total Knee

scholarly journals Recovery Courses of Patients Who Return to Work by 3, 6 or 12 Months After Total Knee Arthroplasty

2021 ◽  
Author(s):  
T. H. Hylkema ◽  
M. Stevens ◽  
J. van Beveren ◽  
P. C. Rijk ◽  
R. W. Brouwer ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Return To Work ◽  
Knee Arthroplasty ◽  
Physical Functioning ◽  
International Classification Of Functioning ◽  
Survey Study ◽  
Activity Limitations ◽  
Physical Impairments ◽  
Participation Restrictions ◽  
Total Knee

AbstractPurpose This study compared the preoperative levels and postoperative recovery courses of physical and mental impairments, activity limitations and participation restrictions of working-age patients who return to work (RTW) by 3, 6 or 12 months after total knee arthroplasty (TKA). Methods A prospective survey study including TKA patients (aged < 65) (n = 146) who returned to work (RdTW) in the first postoperative year. Three groups were compared: those who returned by 3 (n = 35), 6 (n = 40) or 12 (n = 29) months. Surveys were completed preoperatively and at 6 weeks and 3, 6 and 12 months postoperatively. Outcomes represented domains of the International Classification of Functioning, i.e. physical impairments (pain, stiffness, vitality), mental impairments (mental health and depressive symptoms), activity limitations (physical functioning) and participation restrictions (social and work functioning). Results Preoperative knee-specific pain and physical functioning levels were better among patients who RdTW by 3 months, compared to those who returned by 12 months. Patients who RdTW by 3 months experienced significantly better recovery from physical impairments than those who returned by 6 months (on general pain) or 12 months (on general and knee-specific pain and on stiffness). Patients returning by 3 months experienced significantly better recovery from activity limitations (on knee-specific physical functioning). Conclusions To optimize return to work outcome after TKA surgery, the focus should lie on physical impairments (general and knee-specific pain, stiffness) and activity limitations (knee-specific physical functioning) during recovery.

scholarly journals Which patients do not return to work after total knee arthroplasty?

2016 ◽  
Vol 36 (9) ◽  
pp. 1249-1254 ◽  
Author(s):  
P. Paul F. M. Kuijer ◽  
Arthur J. Kievit ◽  
Thijs M. J. Pahlplatz ◽  
Truus Hooiveld ◽  
Marco J. M. Hoozemans ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Return To Work ◽  
Knee Arthroplasty ◽  
Total Knee

scholarly journals Activity levels and return to work following total knee arthroplasty in patients under 65 years of age

2017 ◽  
Vol 99-B (8) ◽  
pp. 1037-1046 ◽  
Author(s):  
C. E. H. Scott ◽  
G. S. Turnbull ◽  
D. MacDonald ◽  
S. J. Breusch
Keyword(s):  
Total Knee Arthroplasty ◽  
Return To Work ◽  
Knee Arthroplasty ◽  
Activity Levels ◽  
Total Knee

scholarly journals Validation of a second-generation appropriateness classification system for total knee arthroplasty: a prospective cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Antonio Escobar ◽  
Amaia Bilbao ◽  
Maria L. Bertrand ◽  
Jesús Moreta ◽  
Miquel A. Froufe ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Second Generation ◽  
Short Form ◽  
Critical Issue ◽  
Research Society ◽  
Public Hospitals ◽  
Preoperative Pain ◽  
Satisfaction Scale ◽  
Total Knee

Abstract Background To test the validity of a second-generation appropriateness system in a cohort of patients undergoing total knee arthroplasty (TKA). Methods We applied the RAND/UCLA Appropriateness Method to derive our second-generation system and conducted a prospective study of patients diagnosed with knee osteoarthritis in eight public hospitals in Spain. Main outcome questionnaires were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short-Form-12 (SF-12), and the Knee Society Score satisfaction scale (KSS), completed before and 6 months after TKA. Baseline, changes from baseline to 6 months (journey outcome), and 6-month scores (destination outcome) were compared according to appropriateness category. Percentage of patients attaining the minimal clinically important difference (MCID) and responders according to Outcome Measures in Rheumatology-Osteoarthritis Research Society (OMERACT-OARSI) criteria were also reported. Results A total of 282 patients completed baseline and 6-month questionnaires. Of these, 142 (50.4%) were classified as Appropriate, 90 (31.9%) as Uncertain, and 50 (17.7%) as Inappropriate. Patients classified as Appropriate had worse preoperative pain, function, and satisfaction (p < 0.001) and had greater improvements (i.e., journey scores) than those classified as Inappropriate (p < 0.001). At 6 months, destination scores for pain, function, or satisfaction were not significantly different across appropriateness categories. The percentage of patients meeting responder criteria (p < 0.001) and attaining MCID was statistically higher in Appropriate versus Inappropriate groups in pain (p = 0.04) and function (p = 0.004). Conclusions The validity of our second-generation appropriateness system was generally supported. The findings highlight a critical issue in TKA healthcare: whether TKA appropriateness should be driven by the extent of improvement, by patient final state, or by both.

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