Page 131 - The value of total hip and knee arthroplasties for patients

Return to work after total hip and knee arthroplasty: a systematic review
size of the femoral head), preoperative function11 and the introduction of a practice guideline aimed at improving hospital length of stay by identifying ‘low-risk patients’6 were found not to be related to postoperative work status.
Three studies reported on determinants of work status afterTKA6, 22, 24, two of which employed a multivariate analysis.6, 24 In one of these two studies the introduction of practice guidelines about appropriate lengths of stay was found not be associated with work status after TKA.6 In another study24, factors associated with a faster return to work were female sex, self-employment, higher mental and physical health scores, higher Functional Comorbidity Index (FCI) scores and a handicap accessible workplace. Factors associated with a slower return to work were having less pain preoperatively (a higher WOMAC pain score), having a more physically demanding job and having workers’ compensation.24
Methodological quality
Table 4 summarizes the results of the methodological quality assessment. The methodological quality of studies was assessed by scoring the presence or likelihood
of selection bias, information bias and statistical analysis bias. The methodological 7 quality for studies on THA was rated high in one study11, moderate in eight studies5,12,14-17,19,20 and low in five studies.4,10,13,18 For studies onTKA,the methodological
quality was rated high in one study24 and moderate in three studies22, 23, 25 The study
on THA and TKA was rated high.6
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