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Multicenter Study
. 2020 Sep;28(9):2905-2916.
doi: 10.1007/s00167-019-05667-0. Epub 2019 Aug 30.

Patients return to work sooner after unicompartmental knee arthroplasty than after total knee arthroplasty

Arthur J Kievit  1 , P Paul F M Kuijer  2 , Laurens J de Haan  3 , Koen L M Koenraadt  3 , Gino M M J Kerkhoffs  4 , Matthias U Schafroth  4 , Rutger C I van Geenen  3
Affiliations
Multicenter Study

Patients return to work sooner after unicompartmental knee arthroplasty than after total knee arthroplasty

Arthur J Kievit et al. Knee Surg Sports Traumatol Arthrosc. 2020 Sep.

Abstract

Purpose: It is not yet known if unicompartmental knee arthroplasty (UKA) patients are more likely to return to work sooner or have improved ability to work (i.e., workability) than total knee arthroplasty (TKA) patients. The following questions were addressed: patients were assessed to determine: (1) whether they returned to work sooner following UKA compared to TKA; (2) whether UKA patients had better WORQ function scores compared to TKA patients; and (3) if UKA patients have higher workability scores and greater satisfaction regarding workability than TKA patients.

Methods: A multicenter retrospective cohort study was performed that included patients at least 2 years after having undergone either UKA or TKA surgery and on the condition that patients had been in work in the 2 years prior to surgery. Time period between stopping work and returning to work was assessed; the WORQ scores (0 = worst-100 = best) and the Work Ability Index (WAI = 0-10) and reported satisfaction with work ability.

Results: UKA patients (n = 157, median 60 years, 51% male) were compared to TKA patients (n = 167, median 60 years, 49% male) (n.s.). Of the 157 UKA patients, 115 (73%) returned to work within 2 years compared to 121 (72%) of TKA patients (n.s.). More UKA patients return to work within 3 months (73% versus 48%) (p < 0.01). WORQ scores improved similarly in both groups. The WAI was also comparable between the groups. Dissatisfaction with workability was comparable (UKA 15% versus TKA 18% (n.s.).

Conclusion: TKA and UKA patients have similar WORQ, WAI, and satisfaction scores. However, in this study population, UKA patients to return to work after surgery significantly sooner than TKA patients, which improves their quality of life and allows them to participate actively in society. This information can help health care providers and patients weigh-up the pros and cons and choose the best treatment and timing for patients in the working population.

Level of evidence: III.

Keywords: Return to work; Total knee arthroplasty; Unicompartmental knee arthroplasty; WORQ; Workability.

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Conflict of interest statement

The authors declare that there is no conflict of interest apart from the unrestricted funding as mentioned above.

Figures

Fig. 1
Fig. 1
Time when patients stopped work before uni and total knee arthroplasty in %
Fig. 2
Fig. 2
Time when patients resumed work after uni and total knee arthroplasty in %
Fig. 3
Fig. 3
Mean difficulty scores for specific knee-burdening activities at three intervals: T0 (before the knee problems arose); T1 (within 3 months before TKA) and; T2 (at 2 years after TKA). Scale 0–100 with 95% CI, for T0, T1, and T2—dimmed bars: red bar % score improvement between T0 and T2
Fig. 4
Fig. 4
Mean difficulty scores for specific knee-burdening activities at three intervals: T0 (before the knee problems arose); T1 (within 3 months before UKA); and T2 (at two years after UKA). Scale 0–100 with 95% CI, for T0, T1, and T2—dimmed bars: green bar % score improvement between T0 and T2
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