How Fast Do Patients Return to Work After Hip, Knee Replacement?

Surgical Rounds®, December 2013,

After identifying a research gap in work status before and after joint replacement, researchers from the Netherlands looked for data describing work status and time to return to work among patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA).

Faced with unacceptable disability, many patients with osteoarthritis of the hip or knee pursue total joint replacement to improve their quality of life and ability to function. Often, their main goal is to continue to work and earn an income.

After identifying a research gap in work status before and after joint replacement, researchers from the Netherlands looked for data describing work status and time to return to work among patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). In addition, the authors attempted to identify factors associated with work status.

The investigators searched databases through April 2013 and gathered clinical studies concerning patients undergoing THA or TKA that provided quantitative information on work status before and after surgery. They considered study characteristics, data on work status, and determinants of return to work.

Selecting 19 studies published between 1986 and 2013 — 4 on THA, 14 on TKA and 1 on both THA and TKA — the authors identified data on 3,872 patients with THA and 649 patients with TKA. After THA, 25-95% of patients returned to work within 12 months, with an average time to return to work of 1.1 to 13.9 weeks. In comparison, 71- 83% returned to work within 6 months after TKA; the average time to return to work after THA was 8 to 12 weeks.

Most patients who wished to return to work were able to do so after THA and TKA. Women, self-employed workers, and those with higher mental and physical health scores seemed more likely to return to work. However, patients were slower to return to work if they had more physically demanding jobs or Worker’s Compensation, which aligned with findings from a similar study that found patients receiving Worker’s Compensation were slower to return to work.

The authors noted that the studies’ methodological quality was moderate to low overall, which hampered their ability to provide the best estimates and impressions. They indicated that standardization of data reporting could help resolve those concerns in the future.