Division of Orthopaedics, University Hospitals Leuven, B-3000 Leuven, Belgium.
Division of Orthopaedics, Department of Development and Regeneration-Organ Systems Cluster, KU Leuven, University Hospitals Leuven, Belgium, B-3000 Leuven, Belgium.
J Knee Surg. 2022 Sep;35(11):1249-1259. doi: 10.1055/s-0040-1722626. Epub 2021 Jan 20.
A growing number of patients undergoing total knee arthroplasty (TKA) is at working age and need to return to work (RTW) after surgery. The aim of this systematic review is to give an overview of the literature regarding RTW after TKA and beneficial and limiting factors influencing this process. A systematic search in four electronic databases was conducted in November 2019 to identify studies describing RTW after primary TKA in patients aged 65 years or younger. Study characteristics and data on work status before and after surgery were extracted. All studies were assessed for risk of bias. Fourteen studies published between 2009 and 2019 were included in this review, accounting for a total of 3,073 patients. The percentage of patients working after TKA ranged from 36 to 89%, and the fraction of patients working before and returning to work after surgery ranged from 40 to 98%. Mean time of RTW ranged from 7.7 to 16.6 weeks. Most important factors associated with a slower or no RTW were a more physical nature of employment and preoperative absence from work. The majority of patients undergoing TKA returned to work postoperatively. However, comparison between studies is seriously hampered by the wide variation regarding the definition and timeframe used to measure the work status. Therefore, standardized outcome measures for studies investigating RTW after TKA are warranted. We identify this review as level-I evidence (systematic review of level-I and level-II studies).
越来越多接受全膝关节置换术 (TKA) 的患者处于工作年龄，并且需要在手术后重返工作岗位 (RTW)。本系统评价的目的是综述有关 TKA 后 RTW 以及影响这一过程的有益和限制因素的文献。2019 年 11 月，我们在四个电子数据库中进行了系统搜索，以确定描述 65 岁以下初次 TKA 后 RTW 的研究。提取了研究特征和手术前后工作状态的数据。所有研究均进行了偏倚风险评估。本综述共纳入了 2009 年至 2019 年期间发表的 14 项研究，共纳入 3073 例患者。TKA 后工作的患者比例从 36%到 89%不等，术前和术后重返工作的患者比例从 40%到 98%不等。RTW 的平均时间范围从 7.7 周到 16.6 周。与 RTW 较慢或无法进行相关的最重要因素是工作性质更具体力性质和术前缺勤。大多数接受 TKA 的患者术后重返工作岗位。然而，由于用于测量工作状态的定义和时间框架存在广泛差异，因此研究之间的比较受到严重阻碍。因此，需要有用于研究 TKA 后 RTW 的标准化结局测量。我们将本综述确定为一级证据（一级和二级研究的系统评价）。
