Predictive Validity of the Work, Osteoarthritis, or Joint Replacement Questionnaire (WORQ) for Return to Work after Total Knee Arthroplasty: A 12-Month Multicenter Prospective Cohort Study

BACKGROUND: After total knee arthroplasty (TKA), a minority of working patients are dissatisfied and experience a late or no return to work (RTW). This study aimed to identify whether a pre-defined grouping based on self-reported ability to perform work-related activities at three months post-TKA was associated with the ability to perform work-related activities at six and 12 months and RTW at three, six, and 12 months post-TKA.

METHODS: A 12-month multicenter prospective cohort study was performed among working TKA patients intending to RTW. The work, osteoarthritis, or joint replacement questionnaire (WORQ) score (range 0 to 100) was used to assess patients' ability to perform work-related activities. Patients were grouped into early-, intermediate-, and late-recovery groups at three months post-TKA. The median age of the cohort (n = 182) was 59 years [IQR [interquartile range] 55 to 62], and 52% were women. Analyses included Spearman's correlation tests, and Kaplan-Meier survival analyses.

RESULTS: The early- (n = 54) and intermediate-recovery groups (n = 68) clinically improved their ability to perform work-related activities at three and 12 months, respectively, while the late-recovery group (n = 60) did not do so until 12 months (r s = 0.6, 0.27, and 0.25, respectively). The early-recovery group returned to work earlier (median 62 [IQR 41 to 90] days) compared to the intermediate- (75 [46 to 115] days) and late-recovery groups (84 [58 to 116] days) and resumed 100 percent of their working hours at six months versus 12 months in the intermediate- and late-recovery groups (r s = 0.37, 0.33, 0.1 at three, six, and 12 months, respectively).

CONCLUSION: At three months post-TKA, the WORQ can be used to distinguish early-, intermediate-, and late-recovery groups, which are associated with the ability to perform work-related activities at six and 12 months post-TKA and RTW at three and six months.