Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, USA.
Department of Sports Medicine, Hospital for Special Surgery, New York, New York, USA.
Am J Sports Med. 2021 Mar;49(3):729-736. doi: 10.1177/0363546520985517. Epub 2021 Feb 3.
Femoroacetabular impingement syndrome (FAIS) is an increasingly common diagnosis among working-age adults. Hip arthroscopy provides reliable improvements in pain and may allow patients to return to physical activities. No study to date has evaluated return to work (RTW) among a general population of adults after arthroscopic surgery for FAIS.
To evaluate (1) patients' rate of RTW, (2) time required to RTW, and (3) factors correlated with time required to RTW after arthroscopic surgery for symptomatic FAIS.
Case series; Level of evidence, 4.
Consecutive patients aged 25 to 59 years who underwent arthroscopic surgery for FAIS between June 2018 and December 2018 were reviewed. Workers' compensation cases and patients with <1-year follow-up were excluded. The following were collected at a minimum of 1 year postoperatively: demographics, employment characteristics, Hip Outcome Score (HOS; Activities of Daily Living and Sports Specific subscales), modified Harris Hip Score, 12-Item International Hip Outcome Tool (iHOT-12), visual analog scale for pain, and RTW characteristics. Work physical activity level was classified as sedentary, light, moderate, heavy, or very heavy per established criteria.
A total of 97 patients were selected through inclusion and exclusion criteria. RTW surveys were collected for 79 (81.4%), and 61 were employed preoperatively. Time worked per week was 42.8 ± 12.5 hours (mean ± SD). Patients' work level was most commonly classified as sedentary (42.6%), followed by moderate (24.6%). All 61 (100%) patients returned to work at a mean 7.3 weeks (range, <1-88 weeks) postoperatively. Sixty patients (95.2%) returned to full duty. Time required to full duty RTW was strongly correlated with expected time off from work ( = 0.900; < .0001) and moderately correlated with work classification ( = 0.640; = .0001). All patients had significant pre- to postoperative improvements in the HOS-Activities of Daily Living (64.8 ± 15.3 to 87.1 ± 12.2; < .001), HOS-Sports Specific (42.8 ± 18.8 to 76.7 ± 16.5; < .001), iHOT-12 (31.3 ± 18.8 to 69.3 ± 21.1; < .001), modified Harris Hip Score (61.8 ± 12.1 to 80.3 ± 14.1; < .001), and visual analog scale for pain (5.19 ± 2.11 to 2.40 ± 1.96; < .001).
Patients undergoing arthroscopic treatment for FAIS demonstrated a high rate of RTW at a mean of <2 months postoperatively. A patient's expected time off from work and the level of physical demands required for work were highly associated with time required to RTW. These results are valuable for orthopaedic surgeons, patients, and employers when establishing a timeline for expected RTW after surgery.
股骨髋臼撞击综合征（FAIS）在工作年龄段的成年人中越来越常见。髋关节镜检查可提供可靠的疼痛改善，并可使患者恢复体育活动。迄今为止，尚无研究评估 FAIS 关节镜手术后一般人群的工作重返率（RTW）。
评估（1）患者的 RTW 率，（2）RTW 所需的时间，以及（3）与 FAIS 关节镜手术后 RTW 所需时间相关的因素。
病例系列；证据水平，4 级。
对 2018 年 6 月至 2018 年 12 月期间因 FAIS 接受关节镜手术的 25 至 59 岁连续患者进行了回顾。排除了工人赔偿案例和随访时间<1 年的患者。术后至少 1 年收集了以下内容：人口统计学资料、就业特征、髋关节结果评分（HOS；日常生活活动和运动特定子量表）、改良 Harris 髋关节评分、12 项国际髋关节结果工具（iHOT-12）、疼痛视觉模拟评分和 RTW 特征。工作体力活动水平根据既定标准分类为久坐、轻度、中度、重度或极重度。
通过纳入和排除标准共选择了 97 名患者。收集了 79 名（81.4%）患者的 RTW 调查，术前有 61 名患者有工作。每周工作时间为 42.8±12.5 小时（平均值±标准差）。患者的工作水平最常见的是久坐（42.6%），其次是中度（24.6%）。所有 61 名（100%）患者在术后平均 7.3 周（<1-88 周）内重返工作岗位。60 名（95.2%）患者恢复全勤工作。全勤工作 RTW 所需时间与预期的休假时间密切相关（ = 0.900；<0.0001），与工作分类中度相关（ = 0.640；<0.0001）。所有患者在 HOS-日常生活活动（64.8±15.3 至 87.1±12.2；<0.001）、HOS-运动特定（42.8±18.8 至 76.7±16.5；<0.001）、iHOT-12（31.3±18.8 至 69.3±21.1；<0.001）、改良 Harris 髋关节评分（61.8±12.1 至 80.3±14.1；<0.001）和疼痛视觉模拟评分（5.19±2.11 至 2.40±1.96；<0.001）方面均有显著的术前至术后改善。
接受 FAIS 关节镜治疗的患者在术后平均<2 个月时表现出较高的 RTW 率。患者预期的休假时间和工作所需的体力活动水平与 RTW 所需的时间高度相关。这些结果对于骨科医生、患者和雇主在手术后确定预期 RTW 时间时非常有价值。
