Return to work after primary total knee replacement in patients under 55 years of age: a retrospective study of 129 cases.

Abstract

Introduction: Primary total knee arthroplasty (TKA) has shown excellent results in the treatment of osteoarthritis, and its indications have now been extended to younger patients of working age. Few articles in the literature have studied the return to work of young subjects, and no specific studies have been conducted in France. Therefore, we carried out a retrospective study to 1) investigate the rate and delay of return to work after primary TKA in a population under 55 years of age and 2) identify factors influencing early return to work before 3 months, the period usually used as the duration of initial work stoppage (TS).

Hypothesis: The hypothesis of this study was that the rate and time to return to work were similar to those of other Western studies.

Materials and methods: This was a single-center retrospective study including all patients under 55 years of age who underwent primary TKA between 2010 and 2019, regardless of their professional status. A questionnaire collected all socioeconomic and medical information, time to return to work, and factors influencing it. Our population consisted of 223 TKAs (201 patients), with a participation rate of 64%. Among 129 patients, with a mean age of 50.3 ± 4.6 years [29-55], 109 were working (84%).

Results: Ninety-four of 109 patients (86.2%) returned to work after surgery at a mean time of 17.3 ± 10.6 weeks [12-24]. Previous hip or knee prosthetic surgery had a significant negative influence on the rate of return to work (OR 0.08; 95% CI [0.008; 0.7] [p = 0.027]). Manual workers returned to work significantly earlier (OR 8.2; 95% CI [1.6; 51.4] [p = 0.017]). A total of 56 patients (43.4%) were off work preoperatively, for a mean time of 16.7 ± 17.8 weeks [4,13-24], and 49 of these patients returned to work (87.5%) at a mean time of 18.7 ± 11 weeks [12-24] compared with patients who did not receive a preoperative work stoppage (WK) (p = 0.7).

Conclusion: The hypothesis was only partially confirmed. Compared with patients in other Western countries, French patients under 55 years of age who underwent primary TKA surgery appeared to return to work at the same rate but with a longer delay. Patients on WT prior to surgery were more likely to return to work after the operation, although this difference did not reach the significance threshold.

Level of evidence iv: Retrospective observational study.