Three Out of Ten Working Patients Expect No Clinical Improvement of Their Ability to Perform Work-Related Knee-Demanding Activities After Total Knee Arthroplasty: A Multicenter Study

Yvonne van Zaanen*, Rutger C.I. van Geenen, Thijs M.J. Pahlplatz, Arthur J. Kievit, Marco J.M. Hoozemans, Eric W.P. Bakker, Leendert Blankevoort, Matthias U. Schafroth, Daniel Haverkamp, Ton M.J.S. Vervest, Dirk H.P.W. Das, Walter van der Weegen, Vanessa A. Scholtes, Monique H.W. Frings-Dresen, P. Paul F.M. Kuijer

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Purpose Three out of ten patients do not return to work after total knee arthroplasty (TKA). Patient expectations are suggested to play a key role. What are patients’ expectations regarding the ability to perform work-related knee-demanding activities 6 months after TKA compared to their preoperative status? Methods A multi-center cross-sectional study was performed among 292 working patients listed for TKA. The Work Osteoarthritis or joint-Replacement Questionnaire (WORQ, range 0–100, minimal important difference 13) was used to assess the preoperatively experienced and expected ability to perform work-related knee-demanding activities 6 months postoperatively. Differences between the preoperative and expected WORQ scores were tested and the most difficult knee-demanding work-related activities were described. Results Two hundred thirty-six working patients (81%) completed the questionnaire. Patients’ expected WORQ score (Median = 75, IQR 60–86) was significantly (p < 0.01) higher than their preoperative WORQ score (Median = 44, IQR 35–56). A clinical improvement in ability to perform work-related knee-demanding activities was expected by 72% of the patients, while 28% of the patients expected no clinical improvement or even worse ability to perform work-related knee-demanding activities 6 months after TKA. Of the patients, 34% expected severe difficulty in kneeling, 30% in crouching and 17% in clambering 6 months after TKA. Conclusions Most patients have high expectations, especially regarding activities involving deep knee flexion. Remarkably, three out of ten patients expect no clinical improvement or even a worse ability to perform work-related knee-demanding activities 6 months postoperatively compared to their preoperative status. Therefore, addressing patients expectations seems useful in order to assure realistic expectations regarding work activities.

Original languageEnglish
Pages (from-to)585-594
Number of pages10
JournalJournal of Occupational Rehabilitation
Volume29
Issue number3
Early online date11 Dec 2018
DOIs
Publication statusPublished - 15 Sep 2019

Keywords

  • Knee arthroplasty, total
  • Patient expectations
  • Treatment outcome
  • Vocational rehabilitation
  • Work ability

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