Page 184 - The value of total hip and knee arthroplasties for patients

Chapter 10
including the patient’s expectations about outcome. Although the CEQ expectancy subscale predicted outcomes slightly better as compared to the HSS expectation surveys, differences in predictive value of the two measurements were too small to recommend the use of one over the other for prediction purposes.
Chapter 7 concerns a systematic literature study on work status and time to return to work and its determinants in patients undergoing THA or TKA.
For this purpose a systematic search in various databases through April 2013 was performed.All clinical studies concerning patients undergoingTHA orTKA providing quantitative information on work status before and after surgery were included. Study characteristics, data on work status and determinants of return to work were extracted and the methodological quality was evaluated regarding three quality aspects (selection bias, information bias and statistical analysis bias).
Nineteen studies (published between 1986 and 2013) were selected (4 on THA, 14 on TKA and 1 on THA and TKA), including 3872 patients with THA and 649 patients withTKA.The proportions of patients returning to work ranged from 25 to 95% at 1-12 months afterTHA and from 71 to 83% at 3-6 months afterTKA.The average time to return to work varied from 1.1 to 13.9 weeks after THA and from 8.0 to 12.0 weeks after TKA. Factors related to work status after THA and TKA included sociodemographic, health and job characteristics. Overall, the methodological quality of the studies was moderate to low.
This study concluded that the majority of patients who are employed before THA and TKA return to work postoperatively. Comparisons of work status and the rate and speed of return to work between studies in THA and TKA are hampered by large variations in patient selection and measurement methods, underpinning the need for more standardization.
Chapter 8 describes a prospective cohort study on return to work and duration until return to work in patients undergoing THA or TKA. It included patients under 65 years of age, who provided information on their work status preoperatively (paid work yes/no and working hours) and 1 year thereafter (paid work yes/no, working hours and time until return to work).
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