Department of Orthopedics, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Occup Rehabil. 2021 Sep;31(3):627-637. doi: 10.1007/s10926-021-09959-6. Epub 2021 Jan 30.
Purpose This study compared the preoperative levels and postoperative recovery courses of physical and mental impairments, activity limitations and participation restrictions of working-age patients who return to work (RTW) by 3, 6 or 12 months after total knee arthroplasty (TKA). Methods A prospective survey study including TKA patients (aged < 65) (n = 146) who returned to work (RdTW) in the first postoperative year. Three groups were compared: those who returned by 3 (n = 35), 6 (n = 40) or 12 (n = 29) months. Surveys were completed preoperatively and at 6 weeks and 3, 6 and 12 months postoperatively. Outcomes represented domains of the International Classification of Functioning, i.e. physical impairments (pain, stiffness, vitality), mental impairments (mental health and depressive symptoms), activity limitations (physical functioning) and participation restrictions (social and work functioning). Results Preoperative knee-specific pain and physical functioning levels were better among patients who RdTW by 3 months, compared to those who returned by 12 months. Patients who RdTW by 3 months experienced significantly better recovery from physical impairments than those who returned by 6 months (on general pain) or 12 months (on general and knee-specific pain and on stiffness). Patients returning by 3 months experienced significantly better recovery from activity limitations (on knee-specific physical functioning). Conclusions To optimize return to work outcome after TKA surgery, the focus should lie on physical impairments (general and knee-specific pain, stiffness) and activity limitations (knee-specific physical functioning) during recovery.
本研究比较了全膝关节置换术后 3、6 和 12 个月重返工作岗位（RdTW）的工作年龄患者的身心损伤、活动受限和参与受限的术前水平和术后恢复过程。
这是一项前瞻性调查研究，纳入了（年龄<65 岁）在术后 1 年内重返工作岗位的 TKA 患者（n=146）。将患者分为三组：术后 3 个月（n=35）、6 个月（n=40）和 12 个月（n=29）内 RdTW 的患者。在术前、术后 6 周以及术后 3、6 和 12 个月进行调查。结果代表国际功能分类的功能领域，即身体损伤（疼痛、僵硬、活力）、精神损伤（心理健康和抑郁症状）、活动受限（身体功能）和参与受限（社会和工作功能）。
与 12 个月内 RdTW 的患者相比，3 个月内 RdTW 的患者术前膝关节特异性疼痛和身体功能水平更好。3 个月内 RdTW 的患者在身体损伤方面的恢复情况明显优于 6 个月（全身疼痛）或 12 个月（全身和膝关节特异性疼痛以及僵硬）内 RdTW 的患者。3 个月内 RdTW 的患者在活动受限方面（膝关节特异性身体功能）的恢复情况明显更好。
为了优化 TKA 手术后的工作回归结果，应在恢复过程中关注身体损伤（全身和膝关节特异性疼痛、僵硬）和活动受限（膝关节特异性身体功能）。
