Return to work and employment retention after uni-compartmental and total knee replacement: findings from the Clinical Outcomes in Arthroplasty study
Return to work and employment retention after uni-compartmental and total knee replacement: findings from the Clinical Outcomes in Arthroplasty study
Background: little is known about ability to work after unicompartmental knee replacement (UKR) and total knee replacement (TKR), especially in physically-demanding occupations. This study described rates of return-to-work (RTW) and ability to sustain work by job after arthroplasty.
Method: participants from The Clinical Outcomes in Arthroplasty Study (COASt) aged 18–65 were eligible if they underwent UKR or TKR and had at least 5 years’ follow-up post-operation. We posted a survey asking about pre-operative occupation, post-operative occupations and associated physical demands, and whether they had quit a job post-surgery due to difficulties with the operated knee (knee-related job loss (KRJL)). We fitted Cox Proportional Hazard Models to investigate the role of demanding physical activities on KRJL.
Results: 251 people (143 UKR, 108 TKR) returned a questionnaire, of whom 101 UKR and 57 TKR worked post-operatively. Rates of RTW were highest amongst those in managerial and professional or technical roles, whichever operation they received. RTW was poorest amongst those in elementary occupations. In associate professional/technical occupations, RTW rates were better amongst UKR recipients. Amongst participants who returned to work, 17 reported KRJL (8.5% UKR and 16.7% TKR). Respondents were more likely to have KRJL if their job involved carrying/lifting ≥10 kg (HR:4.81, 95%CI 1.55–14.93) or climbing >30 flights of stairs (HR:4.03, 95%CI 1.36–11.98).
Conclusions: knee arthroplasty recipients working pre-operatively mostly RTW. RTW may be more difficult after TKR than UKR. Jobs which involve lifting and climbing stairs may be particularly challenging. Surgeons offering knee arthroplasty should counsel patients about workability as well as risk of revision.
245-255
Zaballa Lasala, Elena
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Ntani, Georgia
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Harris, E. Clare
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Arden, Nigel
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Cooper, Cyrus
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Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Zaballa Lasala, Elena
f18e08de-4986-4a7c-b925-849f83d33ddb
Ntani, Georgia
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Harris, E. Clare
3e4bd946-3f09-45a1-8725-d35e80dd7971
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Zaballa Lasala, Elena, Ntani, Georgia, Harris, E. Clare, Arden, Nigel, Cooper, Cyrus and Walker-Bone, Karen
(2022)
Return to work and employment retention after uni-compartmental and total knee replacement: findings from the Clinical Outcomes in Arthroplasty study.
The Knee, 40, .
(doi:10.1016/j.knee.2022.11.022).
Abstract
Background: little is known about ability to work after unicompartmental knee replacement (UKR) and total knee replacement (TKR), especially in physically-demanding occupations. This study described rates of return-to-work (RTW) and ability to sustain work by job after arthroplasty.
Method: participants from The Clinical Outcomes in Arthroplasty Study (COASt) aged 18–65 were eligible if they underwent UKR or TKR and had at least 5 years’ follow-up post-operation. We posted a survey asking about pre-operative occupation, post-operative occupations and associated physical demands, and whether they had quit a job post-surgery due to difficulties with the operated knee (knee-related job loss (KRJL)). We fitted Cox Proportional Hazard Models to investigate the role of demanding physical activities on KRJL.
Results: 251 people (143 UKR, 108 TKR) returned a questionnaire, of whom 101 UKR and 57 TKR worked post-operatively. Rates of RTW were highest amongst those in managerial and professional or technical roles, whichever operation they received. RTW was poorest amongst those in elementary occupations. In associate professional/technical occupations, RTW rates were better amongst UKR recipients. Amongst participants who returned to work, 17 reported KRJL (8.5% UKR and 16.7% TKR). Respondents were more likely to have KRJL if their job involved carrying/lifting ≥10 kg (HR:4.81, 95%CI 1.55–14.93) or climbing >30 flights of stairs (HR:4.03, 95%CI 1.36–11.98).
Conclusions: knee arthroplasty recipients working pre-operatively mostly RTW. RTW may be more difficult after TKR than UKR. Jobs which involve lifting and climbing stairs may be particularly challenging. Surgeons offering knee arthroplasty should counsel patients about workability as well as risk of revision.
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Return to work and employment retention after uni-compartmental and total knee replacement findings from the Clinical Outcomes in Arthroplasty study
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Accepted/In Press date: 26 November 2022
e-pub ahead of print date: 13 December 2022
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Local EPrints ID: 473411
URI: http://eprints.soton.ac.uk/id/eprint/473411
ISSN: 0968-0160
PURE UUID: 3c98d3b4-1408-48f6-ad51-2e11efc4c630
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Date deposited: 17 Jan 2023 17:53
Last modified: 14 Aug 2024 04:01
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Author:
Elena Zaballa Lasala
Author:
E. Clare Harris
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