Feasibility and sustainability of working in different types of jobs after total hip arthroplasty: analysis of longitudinal data from two cohorts

• Published in: Occupational and environmental medicine (London, England) Vol. 79; no. 7; pp. 486 - 493
• Main Authors: Zaballa, Elena, Ntani, Georgia, Harris, E Clare, Lübbeke, Anne, Arden, Nigel K, Hannouche, Didier, Cooper, Cyrus, Walker-Bone, Karen
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.07.2022; BMJ Publishing Group LTD
• Subjects: Arthroplasty, Replacement, Hip - rehabilitation; Arthroplasty, Replacement, Knee - rehabilitation; Biomedical materials; Employment; epidemiology; exercise; Feasibility Studies; Female; Hip; Humans; Joint replacement surgery; Longitudinal studies; Male; Middle Aged; occupational health; Occupations; Orthopaedic implants; osteoarthritis; Practice; Questionnaires; Rehabilitation; Risk analysis; Risk factors; Statistical models; Total hip arthroplasty; Workability; United Kingdom > UK; epidemiology; exercise; occupational health; osteoarthritis; longitudinal studies
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oemed-2021-107970

ObjectivesTo investigate the rates of return to work and workability among working-age people following total hip arthroplasty (THA).MethodsParticipants from the Geneva Arthroplasty Registry and the Clinical Outcomes for Arthroplasty Study aged 18–64 years when they had primary THA and with at least 5 years’ follow-up were mailed a questionnaire 2017–2019. Information was collected about preoperative and post-THA employment along with exposure to physically demanding activities at work or in leisure. Patterns of change of job were explored. Survival analyses using Cox proportional hazard models were created to explore risk factors for having to stop work because of difficulties with the replaced hip.ResultsIn total, 825 returned a questionnaire (response 58%), 392 (48%) men, mean age 58 years, median follow-up 7.5 years post-THA. The majority (93%) of those who worked preoperatively returned to work, mostly in the same sector but higher rates of non-return (36%–41%) were seen among process, plant and machine operatives and workers in elementary occupations. 7% reported subsequently leaving work because of their replaced hip and the risk of this was strongly associated with: standing >4 hours/day (HR 3.81, 95% CI 1.62 to 8.96); kneeling/squatting (HR 3.32, 95% CI 1.46 to 7.55) and/or carrying/lifting ≥10 kg (HR 5.43, 95% CI 2.29 to 12.88).ConclusionsIt may be more difficult to return to some (particularly physically demanding) jobs post-THA than others. Rehabilitation may need to be targeted to these types of workers or it may be that redeployment or job change counselling are required.