影响髋关节和膝关节置换术后重返工作的因素。
Factors influencing return to work after hip and knee arthroplasty.
机构信息
Geraldton Regional Hospital, 51-85 Shenton Street, Geraldton, WA, 6530, Australia.
University of Western Australia, 35 Stirling Hwy, Crawley, WA, 6009, Australia.
出版信息
J Orthop Traumatol. 2019 Jan 14;20(1):9. doi: 10.1186/s10195-018-0515-x.
BACKGROUND
A substantial proportion of patients undergoing lower limb arthroplasty are of working age. This study aims to identify when patients return to work (RTW) and if they return to normal hours and duties, and to identify which factors influence postoperative RTW. The hypothesis is that there is no difference in time of RTW between the different types of surgery, and no difference in time of RTW based on the physical demands of the job.
MATERIALS AND METHODS
Consecutive patients aged < 65 years who had undergone unilateral primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or medial unicompartmental knee arthroplasty (UKA) from 2015 to 2017 were sent a questionnaire. Quantitative questions explored timing and nature of RTW, and qualitative questions explored factors influencing timing of RTW.
RESULTS
There were 116 patients (64 male, 52 female) with an average age of 56 years. Thirty-one patients were self-employed and 85 were employees. Of these patients, 58 had undergone THA, 31 had undergone TKA, and 27 had undergone UKA. One hundred and six (91%) patients returned to work. Patients returned to work after (mean) 6.4 weeks (THA), 7.7 weeks (TKA), and 5.9 weeks (UKA). Time of RTW was not significantly influenced by type of surgery (p = 0.18) (ns). There was a non-significant correlation between physical demands of the work versus time of RTW (p = 0.28) (ns). There was a significantly earlier time of RTW if flexible working conditions were resumed (p = 0.003). Active recovery, motivation, necessity and job flexibility enabled RTW. The physical effects of surgery, medical restrictions and work factors impeded RTW.
CONCLUSION
The time of RTW was not significantly influenced by the type of operation or by the physical demands of the job. Patients returned to work 5.9-7.7 weeks after hip/knee arthroplasty. Rehabilitation, desire, and necessity promoted RTW. Pain, fatigue and medical restrictions impeded RTW.
LEVEL OF EVIDENCE
背景
相当一部分接受下肢关节置换术的患者处于工作年龄。本研究旨在确定患者何时重返工作岗位（RTW），以及他们是否恢复正常工作时间和职责，并确定影响术后 RTW 的因素。假设不同类型的手术之间 RTW 的时间没有差异，并且基于工作的体力要求，RTW 的时间也没有差异。
材料和方法
连续选择 2015 年至 2017 年间接受单侧初次全髋关节置换术（THA）、全膝关节置换术（TKA）或内侧单髁膝关节置换术（UKA）的年龄<65 岁的患者，向他们发送问卷。定量问题探讨 RTW 的时间和性质，定性问题探讨影响 RTW 时间的因素。
结果
共 116 名患者（64 名男性，52 名女性），平均年龄 56 岁。31 名患者为自雇人员，85 名员工。这些患者中，58 人接受了 THA，31 人接受了 TKA，27 人接受了 UKA。106 名（91%）患者重返工作岗位。THA 患者平均（平均）6.4 周后重返工作岗位，TKA 患者 7.7 周后重返工作岗位，UKA 患者 5.9 周后重返工作岗位。手术类型对 RTW 时间没有显著影响（p=0.18）（无统计学意义）。工作体力要求与 RTW 时间之间存在非显著相关性（p=0.28）（无统计学意义）。如果灵活的工作条件得以恢复，RTW 的时间会更早（p=0.003）。积极的康复、动力、必要性和工作灵活性促进了 RTW。手术的身体影响、医疗限制和工作因素阻碍了 RTW。
结论
手术类型或工作体力要求对 RTW 时间没有显著影响。髋关节/膝关节置换术后 5.9-7.7 周患者返回工作岗位。康复、愿望和必要性促进了 RTW。疼痛、疲劳和医疗限制阻碍了 RTW。
证据等级
3 级。
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