Page 121 - The value of total hip and knee arthroplasties for patients
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                                Return to work after total hip and knee arthroplasty: a systematic review
Introduction
In North America and Europe OA of the hip or knee is one of the most prevalent
chronic diseases1 and the most common reason for total joint replacement. By
2009, the number of patients undergoing total hip arthroplasty (THA) and total
knee arthroplasty (TKA) increased to 1.6 and 1.2 per 1000 per year, respectively, in
Western countries.2 These numbers are expected to further increase in the coming
years due to the ageing society and the growing prevalence of obesity.2 Currently a
substantial proportion of these patients (15-45%)5-8 is working (age <65 years) at the
time these procedures are performed. Both from the perspective of the individual
as well as from a socioeconomic point of view it is important to have insight into the
rate and speed of return to work in this patient group.To date, a substantial number
of studies on this topic have been published.A previous systematic review on work
status inTHA andTKA by Kuijer et al.3 aimed to describe determinants of return to
work.The search in that review was restricted to studies published between 1998
and 2008 and concerned two bibliographic databases (PubMed and EMBASE).3
In that review, three studies, all concerning THA, were included. It was found that
the type of operation (two-incision or a mini-posterior approach for THA)4, the 7 provision of no movement restrictions5 and early, protocol-based patient discharge6
were associated with an earlier return to work afterTHA.
To the best of our knowledge, the literature has not been summarized with respect to actual work status before and after surgery, including the rate of and time to return to work in working patients undergoing THA and TKA.Therefore the aim of the present study was to perform a comprehensive, systematic literature review on the rate of and time to return to work after THA or TKA, as well as beneficial and limiting factors affecting return to work.
Methods
Search strategy
In cooperation with a trained librarian (J.W.M.P.), a search strategy was developed (see Supplementary data, available at Rheumatology Online). The search strategy consisted of the AND combination of two main concepts: Work Disability AND (THA ORTKA).The search strategy was developed for PubMed and subsequently
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