Page 20 - The value of total hip and knee arthroplasties for patients

Chapter 1
shows that patients have a very wide range of expectations, in particular regarding daily activities.44 Furthermore, a direct comparison of preoperative expectations regardingTHA orTKA and their fulfilment in a general hospital setting was lacking.44
Return to work after THA and TKA
Currently,a substantial proportion of patients undergoingTHA orTKA (15-45%) is of working age at the time these procedures are performed.46
These proportions are likely to increase as more and more women have a paid employment and the pensionable age is rising in line with the increasing life expectancy.Therefore, 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, only a limited number of studies on this topic have been published. A previous systematic review on work status in THA and TKA by Kuijer et al47 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). In that review three studies, all concerning THA, were included. It was found that type of operation (2- incision or a mini-posterior approach for total hip arthroplasty), the provision of no movement restrictions and early, protocol-based patient discharge were associated with an earlier return to work afterTHA.47
Aims of this thesis
Given the lack of knowledge on the process of recovery after THA or TKA, the current thesis aims:
1. To evaluate the feasibility of a comprehensive set of PROMs, including measures of recovery to normal activities and work , after THA or TKA in a network of 7 collaborating hospitals, by means of a nested study within the Dutch Arthroplasty Register, LROI.
2. To determine the role of radiographic abnormalities as a predictor of recovery afterTHA andTKA.
3. To explore the fulfilment of patients’ preoperative expectations regarding recovery to normal activities and the process of returning to work after THA or TKA as well as barriers and facilitators of return to work.
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