Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, UK.
Knee. 2021 Jun;30:254-266. doi: 10.1016/j.knee.2021.04.015. Epub 2021 May 8.
This study aims to evaluate the current literature with regard to the average time to and overall rate of return to work (RTW) following medial unicompartmental knee arthroplasty (UKA).
A systematic search was conducted on MEDLINE (Ovid), Embase, Pubmed, CINAHL, Web of Science, Scopus, and the Cochrane Library to identify studies reporting RTW after UKA. Primary outcomes were the rate and time to RTW after UKA. Secondary outcomes were postoperative changes in work intensity, functional scores, and factors affecting RTW. Methodological quality was evaluated using the the Methodological Index for Non-Randomized Studies (MINORS) criteria.
Seven studies met inclusion criteria. Results were summarized qualitatively. The overall methodological quality of the studies was moderate based on the MINORS score. These studies included 636 patients with 46.5% male. Mean age was 63.1 years. The average rate of RTW was 81.7%. The average time to RTW was 5.4 ± 3.9 weeks (range 1-32 weeks). 81.8% of patients in one study returned to an equally or more physically demanding job, while 83.5% were able to work the same or longer hours postoperatively in another study. Functional scores improved after surgery (n = 6 studies). Factors affecting RTW were postoperative rehabilitation, retirement, and the effects of surgery.
Limited evidence from the included studies with moderate quality suggests that UKA allows patients to RTW faster, with a high rate of RTW and improved functional outcomes. However, consensus definitions and methods of work status analysis are needed for future studies.
本研究旨在评估有关内侧单间室膝关节置换术后平均重返工作岗位(RTW)时间和总体 RTW 率的现有文献。
系统检索 MEDLINE(Ovid)、Embase、PubMed、CINAHL、Web of Science、Scopus 和 Cochrane 图书馆,以确定报告 UKA 后 RTW 的研究。主要结局是 UKA 后 RTW 的比率和时间。次要结局是术后工作强度、功能评分和影响 RTW 的因素的变化。使用非随机研究方法学指数(MINORS)标准评估方法学质量。
符合纳入标准的研究有 7 项。结果进行了定性总结。根据 MINORS 评分,这些研究的整体方法学质量为中等。这些研究共纳入 636 名患者,其中 46.5%为男性,平均年龄为 63.1 岁。RTW 的平均比率为 81.7%。RTW 的平均时间为 5.4±3.9 周(范围 1-32 周)。一项研究中有 81.8%的患者返回了同等或更具体力要求的工作,另一项研究中有 83.5%的患者术后能够工作相同或更长时间。手术后功能评分有所改善(n=6 项研究)。影响 RTW 的因素包括术后康复、退休和手术的影响。
纳入研究的证据有限,质量中等,表明 UKA 允许患者更快地重返工作岗位,RTW 率高,功能结局改善。然而,未来的研究需要共识定义和工作状态分析方法。