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全髋关节和膝关节置换术后重返工作岗位:系统评价。

Return to work after total hip and knee arthroplasty: a systematic review.

机构信息

Leiden University Medical Center, Department of Orthopaedics J11, PO Box 9600, 2300 RC Leiden, The Netherlands.

出版信息

Rheumatology (Oxford). 2014 Mar;53(3):512-25. doi: 10.1093/rheumatology/ket389. Epub 2013 Nov 23.

Abstract

OBJECTIVES

The aim of this study was to describe work status and time to return to work in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) and to determine which factors are associated with work status.

METHODS

A systematic search strategy in various databases through April 2013 was performed. All clinical studies concerning patients undergoing THA or TKA providing quantitative information on work status before and after surgery were eligible for inclusion. Extracted were study characteristics, data on work status and determinants of return to work. The methodological quality was evaluated in three quality aspects (selection bias, information bias and statistical analysis bias).

RESULTS

Nineteen studies published between 1986 and 2013 were selected (4 on THA, 14 on TKA and 1 on THA and TKA). These studies included 3872 patients with THA and 649 patients with TKA. The proportions of patients returning to work ranged from 25 to 95% at 1-12 months after THA and from 71 to 83% at 3-6 months after TKA. The average time to return to work varied from 1.1 to 13.9 weeks after THA and from 8.0 to 12.0 weeks after TKA. Factors related to work status after THA and TKA included sociodemographic, health and job characteristics. Overall, the methodological quality of the studies was moderate to low.

CONCLUSION

The majority of patients who are employed before THA and TKA return to work postoperatively. Comparisons of work status and the rate and speed of return to work between studies in THA and TKA are hampered by large variations in patient selection and measurement methods, underpinning the need for more standardization.

摘要

目的

本研究旨在描述行全髋关节置换术(THA)或全膝关节置换术(TKA)患者的工作状态和重返工作岗位的时间,并确定哪些因素与工作状态相关。

方法

通过 2013 年 4 月在各种数据库中进行系统的检索策略。所有关于行 THA 或 TKA 的临床研究,提供手术前后工作状态的定量信息,均符合纳入标准。提取的内容包括研究特征、工作状态数据以及重返工作岗位的决定因素。从选择偏倚、信息偏倚和统计分析偏倚三个质量方面评估方法学质量。

结果

选择了 1996 年至 2013 年间发表的 19 项研究(4 项关于 THA,14 项关于 TKA,1 项关于 THA 和 TKA)。这些研究包括 3872 例 THA 患者和 649 例 TKA 患者。THA 术后 1-12 个月返回工作岗位的患者比例为 25%至 95%,TKA 术后 3-6 个月返回工作岗位的患者比例为 71%至 83%。THA 后返回工作的平均时间为 1.1 至 13.9 周,TKA 后为 8.0 至 12.0 周。与 THA 和 TKA 后工作状态相关的因素包括社会人口统计学、健康和工作特征。总体而言,这些研究的方法学质量为中等至较低。

结论

大多数在 THA 和 TKA 前有工作的患者在术后会返回工作岗位。THA 和 TKA 之间的工作状态、重返工作岗位的比率和速度的比较受到患者选择和测量方法的较大差异的阻碍,这突出表明需要更多的标准化。

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