Orthopedics. 2020 Sep 1;43(5):e415-e420. doi: 10.3928/01477447-20200619-12. Epub 2020 Jul 7.
Returning to work after surgery is a primary concern of patients who are contemplating total joint arthroplasty (TJA). The ability to return to work has enormous influence on the patient's independence, financial well-being, and daily activities. The goal of this study was to determine the independent patient variables that predict return to work as well as to create a predictive model. From June 2017 to December 2017, a total of 391 patients who underwent primary TJA (243 hips, 148 knees) were prospectively enrolled in the study to obtain information on return to work after surgery. Patients were sent a series of questions in a biweekly survey. Information was collected on the physical demands of their occupation, the number of hours spent standing, the limitations to return to work, and the use of assistive devices. Bivariate analysis was performed, and a multiple linear regression model was created. Most (89.6%) patients returned to work within 12 weeks of surgery. Patients who underwent total hip arthroplasty returned to work earlier than those who underwent total knee arthroplasty (5.56 vs 7.79 weeks, respectively). Analysis showed the following independent predictors for faster return to work: self-employment, availability of light-duty work, male sex, and higher income. Predictors for slower return to work included a physically demanding occupation (at least 50% physical duties), knee arthroplasty, longer length of stay, and a job requiring more hours spent standing. This model reported an adjusted R of 0.332. The findings provide an objective predictive model of the patient- and procedure-specific characteristics that affect postoperative return to work. Surgeons should consider these factors when counseling patients on their postoperative expectations. [Orthopedics. 2020;43(5):e415-e420.].
术后重返工作岗位是考虑行全关节置换术（TJA）的患者的主要关注点。能否重返工作岗位对患者的独立性、经济状况和日常活动有巨大影响。本研究旨在确定可预测术后重返工作岗位的独立患者变量，并建立预测模型。2017 年 6 月至 2017 年 12 月，前瞻性纳入 391 例初次 TJA 患者（243 髋，148 膝），以获取术后重返工作岗位的信息。患者每隔两周会收到一系列问题的调查。收集的信息包括职业的体力需求、站立时间、重返工作的限制以及辅助设备的使用。进行了单变量分析，并建立了多元线性回归模型。大多数（89.6%）患者在手术后 12 周内重返工作岗位。全髋关节置换术患者比全膝关节置换术患者更早返回工作岗位（分别为 5.56 周和 7.79 周）。分析显示更快返回工作的独立预测因素为：个体经营、提供轻体力工作、男性和较高收入。较慢返回工作的预测因素包括：体力要求高的职业（至少 50%体力工作）、膝关节置换术、住院时间较长和需要站立时间更长的工作。该模型的调整 R 为 0.332。研究结果提供了一个客观的预测模型，说明了影响术后重返工作岗位的患者和手术特定特征。外科医生在向患者提供术后预期时应考虑这些因素。
