Return to Work Following Knee Arthroplasty

There is sparsity although increasing data about the variety of outcomes following total knee arthroplasty in the working population. On average, one in three patients do not return to work after knee arthroplasty. Patients return to work around 12 weeks post-surgery, although large differences exist between patients and full return to work may take more than 6 months. The cause for not returning to work is multifactorial, but known prognostic factors are preoperative sick-leave of more than 2 weeks, female sex, high BMI, patient-reported work-relatedness of knee symptoms, and physically demanding jobs. Age and KOOS scores are not associated with return to work. At present, no studies are available that evaluated the effect of exercise-based rehabilitation, active referral to an occupational physician or therapist, or other forms of multidisciplinary care for knee arthroplasty on return to work. Promising interventions for return to work are better expectation management by setting pre-operative patient-centred realistic work-related activity goals, pre-operative referral to an occupational physician or therapist to actively address prognostic factors hindering return to work, and the use of personalized e/mHealth including activity trackers to support knee arthroplasty patients on a daily basis in return to work.