Income among independent predictors of faster return to work after TJA
Male sex, high income and self-employment are predictors of faster return to work after total joint arthroplasty, while having a physically demanding job and longer length of stay are linked with slower return to work, according to a study.
Alexander J. Rondon, MD, MBA, and colleagues at Rothman Orthopaedic Institute prospectively studied 391 patients who underwent TJA (243 hips, 148 knees) at a single institution between June 2017 and December 2017.
All patients completed a biweekly REDCAP survey, which reported on clinical, demographic and occupational data, for 12 weeks following their TJA procedures. Patients were queried on procedure type, insurance status, narcotic use, preoperative ambulatory status, assistive device use, age, sex, BMI, occupation, physicality of occupation, number of hours spent standing at work and self-employment status, according to the study.
The most common patient occupations included actor, chef, professor, lawyer, accountant, physician, physical laborer and teacher.
Researchers performed bivariate analysis and created a multiple linear regression model to assess independent predictive variables.
Within 12 weeks of surgery, 89.6% of patients (n = 349) had returned to work. Patients who underwent total hip arthroplasty returned to work 2.23 weeks earlier than those who underwent total knee arthroplasty (5.56 weeks vs. 7.79 weeks, respectively).
According to the study, predictors of a faster return to work included male sex, higher income, self-employment, white collar occupation, lower physical job requirements, availability of light-duty work, reduced hours spent standing, THA (as compared with TKA) and reduced length of stay.
“Setting appropriate patient expectations for the ability to return to work after surgery is a necessary component of preoperative counseling,” the researchers wrote in the study. “The current study provides arthroplasty surgeons with a model to better predict when a patient can expect to return to work based on patient-specific, employment-specific and procedure-specific risk factors.”