How fast can I return to work after knee replacement? 15 to 30% of patients do not return to work

Danielle Steilen-Matias, MMS, PA-CIn this article Danielle Steilen-Matias, PA-C of Caring Medical Regenerative Medicine Clinics discusses research concerning return to work after knee replacement.

The question for many facing knee replacement is not IF they can return to work, but WHEN?  The longer the delay the greater out of pocket expense, lost work time, lost salary, especially among the self-employed with physically demanding jobs.

Compared to the amount of research on knee replacement procedures, outcomes, and failure protocols, there is only a small amount of research information focused on giving doctors helpful information to offer knee replacement patients in helping them back to work. In fact, the most recent studies on this subject are focused themselves on the lack of research and the lack of support in helping workers get back to the job. Here is the dilemma according to researchers:

15 to 30% of patients do not return to work after knee replacement

A study by a team of Canadian doctors published in the Annals of Physical and Rehabilitation Medicine, made this assessment:

“Total knee arthroplasty (replacement) is an effective intervention for people with osteoarthritis. However, 15 to 30% of patients do not return to work, and studies frequently fail to provide an explanation of what may lead to work disability. . . “(1)

Returning to work after knee replacement – getting the realistic assessment

Doctors in the United Kingdom examined the return to work experience in patients who had knee replacement surgery. Their study findings published in the British Medical Journal surrounded the asking of 7 questions to patients POST-knee replacement.

  1. Could you start explaining to me what your job involves?
  2. How did your arthritis affect you/your work?
  3. What happened since your operation?
  4. Was the experience after the operation what you were expecting?
  5. What was the involvement of your employer?
  6. Is there anything that has helped you/ or would have helped you to return to work more easily?
  7. What influenced the decision to return to work at that time?

A big problem: post knee replacement information and rehab centers on the retired, longer-term outcomes, such as return to work, were not routinely discussed.

  • The patients in this study found that the advice they received from healthcare professionals focused on the needs of the elderly and retired population.
  • Preoperative education reportedly focused on the inpatient stay and immediate postoperative period, but longer-term outcomes, such as return to work, were not routinely discussed.
  • In summary: Patients found that work-related activities were not discussed and focused on people of a certain age and people who didn’t work.(2)

The patient’s ability to make a living

In other words, the question of when can I return to work was not satisfactorily addressed for many. Some patients went to work when they felt like they needed to, some stayed out of work waiting for doctor’s clearance.

  • Doctors top priority in recommending knee replacement: Pain and Function
  • Patients to priority: Function and get back to work

Researchers writing in the Medical Journal of Australia, wanted to know what influenced surgeons in determining the order in which patients are scheduled for surgery. In their study, they asked a group of surgeons to assess patient profiles of 80 patients. They also asked a group of non-medical personal (lay people) to assess the patient profiles for their “lay” recommendation.

  • Both groups determined that the patient’s pain was the number one concern.
  • For the surgeons, the other determining factors were physical limitations and other medical factors.
  • The lay people saw it a little differently. While agreeing on the physical limitation part, they were concerned with the patient’s socio-economic situation and the stress a prolonged wait would bring on the patient’s ability to make a living as well as the psychological distress that may bring.(3)

While the surgeons did not consider socio-economic factors in determining priority in patients wait time to surgery, it is clear that for the lay person, the delay to surgery, the surgery, and the recovery time from a total knee replacement are important factors.

There is little in the literature to guide clinicians in advising patients regarding their return to work following a primary total knee replacement

One of the reasons the surgeons may not have prioritized this factor may be found in the literature. Researchers at the Case Western Reserve University School of Medicine. in their study published in the Journal of joint and bone surgery, wrote:

“There is little in the literature to guide clinicians in advising patients regarding their return to work following a primary total knee (replacement). (This study) aimed to identify which factors are important in estimating a patient’s time to return to work. . .how long patients can anticipate being off from work, and the types of jobs to which patients are able to return following primary total knee arthroplasty.”(4)

Information for patients to assess from the study scores were:

  • The average time to return to work after the surgery was nine weeks.
  • Patients who reported a sense of urgency about returning to work were found to return in half the time taken by other employees
  • Other preoperative factors associated with a faster return to work included being female, self-employment, higher mental health scores, higher physical function scores, higher functional comorbidity, and a handicap accessible workplace.
  • A slower return to work was associated with having less pain preoperatively, having a more physically demanding job, and receiving Workers’ Compensation

Information for patients to assess from the study scores were:

  • The average time to return to work after the surgery was nine weeks.
  • Patients who reported a sense of urgency about returning to work were found to return in half the time taken by other employees
  • Other preoperative factors associated with a faster return to work included being female, self-employment, higher mental health scores, higher physical function scores, higher functional comorbidity, and a handicap accessible workplace.
  • A slower return to work was associated with having less pain preoperatively, having a more physically demanding job, and receiving Workers’ Compensation.

If you are on this page because you are seeking alternatives to knee replacement, let’s continue on with these articles on your options:

If you have questions about knee replacement options

1 Maillette P, Coutu MF, Gaudreault N. Workers’ perspectives on return to work after total knee arthroplasty. Annals of physical and rehabilitation medicine. 2017 Sep 1;60(5):299-305. [Google Scholar]

2 Bardgett M, Lally J, Malviya A, Deehan D. Return to work after knee replacement: a qualitative study of patient experiences. BMJ Open. 2016 Jan 1;6(2):e007912. [Google Scholar]

3. Curtis AJ, Wolfe R, Russell CO, Elliott BG, Hart JA, McNeil JJ. Determining priority for joint replacement: comparing the views of orthopaedic surgeons and other professionals. Med J Aust. 2011 Dec 5;195(11):699-702. [Google Scholar]

4. Styron JF, Barsoum WK, Smyth KA, Singer ME. Preoperative predictors of returning to work following primary total knee arthroplasty. J Bone Joint Surg Am. 2011 Jan 5;93(1):2-10. [Google Scholar]

Make an Appointment |

Subscribe to E-Newsletter |

Print Friendly, PDF & Email
Find out if you are a good candidate
First Name:
Last Name:
Phone:
Email:
Question:

Enter code:
captcha
Facebook Reviews Facebook Oak Park Office Review Facebook Fort Myers Office Review
SEARCH
for your symptoms
Prolotherapy, an alternative to surgery
Were you recommended SURGERY?
Get a 2nd opinion now!
WHY TO AVOID:
★ ★ ★ ★ ★We pride ourselves on 5-Star Patient Service!Come see why patients travel from all
over the world to visit our clinics.
Current Patients
Become a New Patient

Chicagoland Office
715 Lake St., Suite 600
Oak Park, IL 60301
(708) 393-8266 Phone
(855) 779-1950 Fax
Southwest Florida Office
9738 Commerce Center Ct.
Fort Myers, FL 33908
(239) 308-4701 Phone
(855) 779-1950 Fax Fort Myers, FL Office
We are an out-of-network provider.
© 2018 | All Rights Reserved | Disclaimer
National Prolotherapy Centers specializing in Comprehensive Prolotherapy,
Stem Cell Therapy, and Platelet Rich Plasma.

Meet our Prolotherapy Doctors and check out our Prolotherapy research.