Total knee arthroplasty in patients on workers' compensation: a matched cohort study with an average follow-up of 4.5 years.

Little information in the literature exists regarding the outcome of total knee arthroplasty (TKA) in patients who are on workers' compensation (WC). Twenty-one WC patients who underwent 23 TKA procedures (cases) were compared with 16 randomly selected, age-matched control patients (controls) undergoing 21 TKA procedures. The mean follow-up was 56 months (34-112 months) for both groups. The results were evaluated using the scoring system of the Knee Society (KSS). Significant improvements in KSS were noted in both groups, and all subjects indicated that they would undergo the procedure again. The KSS were statistically better in the control group relative to the WC group. There was no difference in range of motion, stability, or radiographic alignment. Despite high satisfaction with the results of surgery in both groups, only 5 of 21 patients in the WC group returned to their previous occupation. TKA improves pain and function scores in WC patients with end-stage knee disease. Understanding how WC issues affect the results of TKA is critical to the selection of appropriate surgical candidates.