Wolf Jennifer Moriatis, Atroshi Isam, Zhou Caddie, Karlsson Jon, Englund Martin
Department of Orthopedic Surgery, University of Chicago Hospitals, Chicago, IL; Department of Clinical Sciences-Orthopedics, Faculty of Medicine, Lund University, Lund, Sweden.
Department of Clinical Sciences-Orthopedics, Faculty of Medicine, Lund University, Lund, Sweden; Department of Orthopedics Hässleholm-Kristianstad, Hässleholm Hospital, Hässleholm, Sweden.
J Hand Surg Am. 2018 May;43(5):439-447. doi: 10.1016/j.jhsa.2017.11.019. Epub 2018 Feb 7.
Patients undergoing surgery for thumb carpometacarpal (CMC1) osteoarthritis often require sick leave owing to postoperative immobilization, pain, and decreased function. Our goal was to evaluate the amount of sick leave after surgery for 2 common CMC1 arthroplasty procedures.
Using registry data from the Skåne region of southern Sweden, cross-linked with employment data showing person-specific sick leave, 2 cohorts of CMC1 surgical patients, between ages 40 and 59 years, were examined. These comprised all persons undergoing soft tissue arthroplasty and prosthetic implant arthroplasty from 2004 to 2012 identified using International Classification of Diseases, 10th Revision, and surgical codes. These subjects were analyzed against an age- and sex-matched reference population cohort.
Surgical cohorts of 326 and 169 subjects undergoing soft tissue and prosthetic CMC1 arthroplasty, respectively, were compared with reference populations of 1,110 and 574 persons. Surgical subjects had a pronounced increase in sick leave in the first 2 months after surgery, followed by diminishing days of leave over time. Mean sick leave time after soft tissue arthroplasty was 202 days in women and 170 days in men. Following prosthetic arthroplasty, mean sick leave was 177 days in women and 188 in men. When we excluded those with documented sick leave in the month before surgery (owing to preoperative CMC1 disability or other medical issues), the mean postoperative sick leave decreased to 137 days in women and 125 days in men after soft tissue arthroplasty compared with 109 and 94 days in women and men after prosthetic implant arthroplasty, and this difference was significant. There were no differences in the length of sick leave between sexes and no correlation with age.
Soft tissue arthroplasty and implant arthroplasty for patients with CMC1 osteoarthritis are both associated with substantial sick leave time, indicating the impact of surgery on return to work. There were no differences in sick leave by sex or age.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
因拇指腕掌关节（CMC1）骨关节炎接受手术的患者，常因术后固定、疼痛及功能减退而需要请病假。我们的目标是评估两种常见的CMC1关节置换手术术后的病假时长。
利用瑞典南部斯科讷地区的登记数据，并与显示个人病假情况的就业数据交叉比对，对两个队列的年龄在40至59岁之间的CMC1手术患者进行了检查。这些患者包括2004年至2012年间所有使用国际疾病分类第十版及手术编码确定的接受软组织关节置换术和假体植入关节置换术的患者。将这些受试者与年龄和性别匹配的参考人群队列进行分析比较。
分别对326名接受软组织CMC1关节置换术和169名接受假体CMC1关节置换术的手术队列受试者，与1110名和574名参考人群进行了比较。手术受试者术后头两个月病假天数显著增加，随后随着时间推移病假天数逐渐减少。软组织关节置换术后，女性平均病假时间为202天，男性为170天。假体关节置换术后，女性平均病假时间为177天，男性为188天。当我们排除术前一个月有病假记录的患者（由于术前CMC1功能障碍或其他医疗问题）后，软组织关节置换术后女性平均术后病假天数降至137天，男性降至125天，而假体植入关节置换术后女性和男性分别为109天和94天，且这种差异具有统计学意义。病假时长在性别之间无差异，与年龄也无相关性。
CMC1骨关节炎患者的软组织关节置换术和植入关节置换术均与较长的病假时间相关，表明手术对重返工作岗位有影响。病假时长在性别和年龄方面无差异。
研究类型/证据水平：预后性研究II级。
