Alexander Hoorntje1, Claudia S Leichtenberg2, Koen L M Koenraadt3, Rutger C I van Geenen3, Gino M M J Kerkhoffs4, Rob G H H Nelissen2, Thea P M Vliet Vlieland5, P Paul F M Kuijer6. 1. Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands; Department of Orthopaedic Surgery, Foundation FORCE (Foundation for Orthopaedic Research Care and Education), Amphia Hospital, Breda, The Netherlands. 2. Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Orthopaedic Surgery, Foundation FORCE (Foundation for Orthopaedic Research Care and Education), Amphia Hospital, Breda, The Netherlands. 4. Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands; Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands. 5. Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands; Sophia Rehabilitation Center, The Hague, The Netherlands; Netherlands Rijnlands Rehabilitation Center, Leiden, The Netherlands. 6. Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Abstract
BACKGROUND: After total knee arthroplasty (TKA), 17%-60% of the patients do not or only partially return to work (RTW). Reasons for no or partial RTW remain unclear, warranting further research. Physical activity (PA) has proven beneficial effects on work participation. Therefore, we hypothesized that preoperative PA is associated with RTW after TKA. METHODS: Working TKA patients participating in an ongoing prospective cohort study were included. Preoperatively and 1 year postoperatively, patients were asked to define their work status and PA level according to the Dutch Recommendation for Health-Enhancing PA and the Fitnorm. Multivariate logistic regression analysis was performed to assess the effect of PA on RTW, taking into account established prognostic factors for RTW among TKA patients. RESULTS: Of 283 eligible patients, 266 (93%) completed the questionnaires sufficiently. Preoperatively, 141 patients (54%) performed moderate PA for ≥5 d/wk and 42 (16%) performed intense PA for ≥3 d/wk. Concerning RTW, 178 patients (67%) reported full RTW, 59 patients (22%) partial RTW, and 29 patients (11%) no RTW. Preoperative PA was not associated with RTW. Patients who reported that their knee symptoms were not or only partially work-related had lower odds of no RTW (odds ratio 0.37, 95% confidence interval 0.17-0.81). Also, for each additional week patients expected to be absent from work, the likelihood of no RTW increased (odds ratio 1.11, 95% confidence interval 1.03-1.18). CONCLUSION: No association between preoperative PA and RTW after TKA was found. Patient beliefs and preoperative expectations did influence RTW and should be addressed to further improve RTW after TKA.
BACKGROUND: After total knee arthroplasty (TKA), 17%-60% of the patients do not or only partially return to work (RTW). Reasons for no or partial RTW remain unclear, warranting further research. Physical activity (PA) has proven beneficial effects on work participation. Therefore, we hypothesized that preoperative PA is associated with RTW after TKA. METHODS: Working TKA patients participating in an ongoing prospective cohort study were included. Preoperatively and 1 year postoperatively, patients were asked to define their work status and PA level according to the Dutch Recommendation for Health-Enhancing PA and the Fitnorm. Multivariate logistic regression analysis was performed to assess the effect of PA on RTW, taking into account established prognostic factors for RTW among TKA patients. RESULTS: Of 283 eligible patients, 266 (93%) completed the questionnaires sufficiently. Preoperatively, 141 patients (54%) performed moderate PA for ≥5 d/wk and 42 (16%) performed intense PA for ≥3 d/wk. Concerning RTW, 178 patients (67%) reported full RTW, 59 patients (22%) partial RTW, and 29 patients (11%) no RTW. Preoperative PA was not associated with RTW. Patients who reported that their knee symptoms were not or only partially work-related had lower odds of no RTW (odds ratio 0.37, 95% confidence interval 0.17-0.81). Also, for each additional week patients expected to be absent from work, the likelihood of no RTW increased (odds ratio 1.11, 95% confidence interval 1.03-1.18). CONCLUSION: No association between preoperative PA and RTW after TKA was found. Patient beliefs and preoperative expectations did influence RTW and should be addressed to further improve RTW after TKA.
Authors: T H Hylkema; M Stevens; J van Beveren; P C Rijk; R W Brouwer; S K Bulstra; P P F M Kuijer; S Brouwer Journal: J Occup Rehabil Date: 2021-01-30
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Authors: Alexander Hoorntje; Suzanne Waterval-Witjes; Koen L M Koenraadt; P Paul F M Kuijer; Leendert Blankevoort; Gino M M J Kerkhoffs; Rutger C I van Geenen Journal: J Bone Joint Surg Am Date: 2020-08-19 Impact factor: 6.558