TKA Enables Patients to Return to Life, Work

Total knee arthroplasty (TKA) is an incredibly successful surgery, enabling 98 percent of patients who were working before surgery to return to work after surgery, according to research presented yesterday. Coauthor Ryan M. Nunley, MD, noted that 89 percent of those patients returned to their previous position. Although those patients with sedentary occupations had the highest rate of return to their usual work, even those with very heavy jobs returned to their same job 88 percent of the time.

The multicenter study, which aimed to answer the question “Do Patients Return to Work after Total Knee Arthroplasty?” used an independent, third-party survey center. The center provided questionnaires and interviewed more than 660 TKA patients (ages 18 to 60 years) from five major medical centers 1 to 5 years after surgery. Definitions from the U.S. Department of Labor’s Dictionary of Occupational Titles were used to categorize the patients’ physical job demands as sedentary, light, medium, heavy, or very heavy.

Complete data were collected on 661 TKA patients (average age, 54.2 years; 61.3 percent female). Dr. Nunley reported the following data:

Nearly 75 percent of patients (493) were employed during the 3 months prior to their TKA, and 98 percent returned to work after surgery. Of these patients, 89 percent successfully returned to the job they had prior to surgery.
Approximately 13 percent of the patients had sedentary jobs; 11 percent, light jobs; 24 percent, medium; 23 percent, heavy; and 29 percent, very heavy.
Among those with sedentary jobs, the return-to-work rate was 95 percent; it was 91 percent among those with jobs deemed to be light, 100 percent for those with medium job demands, 98 percent for those with heavy job demands, and 97 percent for those with very heavy job demands.

Men were more likely than women to have worked during the 3 months before surgery (83 percent versus 70 percent), but the return-to-work rates were similar for both employed men (96 percent) and employed women (99 percent).

“When pain and suffering from end-stage degenerative joint disease of the knee compromises a patient’s ability to maintain gainful employment, TKA is successful in keeping the patient in the work force,” said lead study author Adolph V. Lombardi, Jr, MD. “Returning to work not only gives the patient a sense of fulfillment, but also is economically beneficial to our society.”

In addition to Dr. Lombardi, Dr. Nunley’s coauthors for Scientific Presentation 426, “Do Patients Return to Work After Total Knee Arthroplasty?” include Keith R. Berend, MD; Erin L. Ruh, MS; John C. Clohisy, MD; William G. Hamilton, MD; Craig J. Della Valle, MD; Javad Parvizi, MD, FRCS; and Robert L. Barrack, MD.

Disclosure information: Dr. Lombardi—Biomet; Innomed; Stryker; Clinical Orthopaedics and Related Research (CORR); Journal of Arthroplasty (JOA); Journal of Bone and Joint Surgery–American (JBJS Am); Journal of the American Academy of Orthopaedic Surgeons (JAAOS); Journal of Orthopaedics and Traumatology; Surgical Technology International; Orthopaedic Research and Education Foundation (OREF); The Hip Society; Knee Society; New Albany Surgical Hospital Foundation. Dr. Nunley—Smith & Nephew; Wright Medical Technology; Medtronic; CardioMEMS; Integra Sciences; Biomet; Stryker; EOS Imaging; Medical Compression Systems; Missouri State Orthopaedic Association; Southern Orthopaedic Association. Dr. Berend—Biomet; CORR; JOA; JBJS Am; Orthopedics; American Association of Hip and Knee Surgeons (AAHKS). Ms. Ruh—no conflicts. Dr. Clohisy—Biomet; Pivot Medical; Wright Medical Technology; Zimmer; JBJS Am. Dr. Hamilton—DePuy, a Johnson & Johnson Company; Medtronic; Inova Health Care Services; Biomet. Dr. Della Valle—Biomet; ConvaTec; Smith & Nephew; CD Diagnostics; Stryker; JBJS Am; SLACK Incorporated; Orthopedics Today; AAHKS; Arthritis Foundation; Knee Society. Dr. Parvizi—Cadence; 3M; CeramTec; Pfizer; Salient Surgical; Smith & Nephew; TissueGene; Zimmer; Baxter; DePuy, a Johnson & Johnson Company; Musculoskeletal Transplant Foundation; National Institutes of Health (NIH) (NIAMS & NICHD); Stryker; Jaypee; JOA; JBJS Am; Saunders/Mosby-Elsevier; SLACK Incorporated; Wolters Kluwer Health–Lippincott Williams & Wilkins; American Journal of Orthopedics; Current Opinion in Orthopaedics; International Orthopaedics; JBJS British; JAAOS; Magnifi Group; Orthopedics Today; AAHKS; American Board of Orthopaedic Surgery, Inc.; British Orthopaedic Association; CD Diagnostics; Eastern Orthopaedic Association; The Hip Society; OREF; Orthopaedic Research Society; Philadelphia Orthopaedic Society; SmartTech; United Healthcare.
Dr. Barrack—Stryker Orthopaedics; Biomet; EOS Imaging; Medical Compression Systems; NIH (NIAMS & NICHD); Smith & Nephew; Wright Medical Technology; McGraw-Hill Companies; Wolters Kluwer Health–Lippincott Williams & Wilkins; AAHKS; American Orthopaedic Association; The Hip Society; Knee Society.

2013 Annual Meeting News
Tuesday through Friday, February 19 – 23, 2013.
http://www.aaos.org/news/acadnews/2013/AAOS16_3_22.asp