Page 159 - The value of total hip and knee arthroplasties for patients
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                                Return to work after total hip and knee arthroplasty: results from a clinical study
patients who were working preoperatively and had returned to work (n = 64 and n = 56) as compared to those who had not returned to work after 1 year and were not retired (n = 5 and n = 6), did not show any statistically significant differences for the THA and TKA patient groups, respectively.
Discussion
This prospective study in patients undergoing THA and TKA showed that the large majority of patients who were working preoperatively returned to work 1 year after surgery.The mean time to return to work was 12 weeks.About 15–20 % of the patients returning to work worked less hours as compared to their preoperative work status. Only few patients under 65 years who were not working preoperatively were gainfully employed after 1 year.
Regarding the rate of working THA and TKA patients returning to work postoperatively, a comparison with the literature is hampered by the limited number
of available studies, as well as by differences in study designs, in particular with
respect to the selection of patients and duration of follow-up. A systematic review
of the literature performed by our own group6 showed that in the studies describing
return to work, the proportions of patients returning to work ranged from 25 to 95 8 % at 1–12 months after THA (n = 7 studies) and from 71 to 83 % at 3–6 months
after TKA (n = 2 studies).6 Only two studies included in this systematic review measured the proportion of patients returning to work at 1 year after surgery, both focused on THA patients. They showed that at 1 year after THA surgery 95/139 patients (68.3 %)28 and 38/44 patients (86 %)29 had returned to work, respectively. In addition, Sankar et al.13 found that 87 % of workingTHA and 85 % ofTKA patients had returned to work after 1 year. These results, from Bohm et al.29 and Sankar et al.13, are strikingly consistent with our results after 1 year (88 % in THA and 86 % in TKA). After the review was published, a retrospective study by Kievit et al.14 showed that after a mean follow-up of 3.8 (1.3 SD) years after surgery 68 % of TKA patients had returned to work. It remains to be established to what extent this relatively lower proportion as compared to the present study was caused by patients not returning to work because of knee complaints or other reasons, such as the reaching the pensionable age.The most recent study, by Lombardi et al.15, found a higher rate of 98 % of patients who underwent TKA returning to work. Even if
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