Purpose <p>Total hip arthroplasty (THA) and total knee arthroplasty (TKA) as treatments for osteoarthritis increasingly affect working-age adults. However, little is known about the development of work ability after THA and TKA. This study investigated different trajectory classes of work ability after THA and TKA.</p> Methods <p>This prospective study included 146 working patients (THA n = 51, TKA n = 95). They received THA/ TKA treatment as usual, including surgery, rehabilitation, and optional post-rehabilitation programmes. The primary outcome work ability was assessed five times (before surgery, end of rehabilitation, 3-month, 6-month, and 12-month follow-up) with the Work Ability Score. Additionally, the questionnaires included sociodemographic, health-, rehabilitation-, and work-related data. We applied a latent class growth analysis to identify distinct trajectory classes of work ability over 12&#xa0;months, and examined associated factors using univariable multinominal logistic regression analyses in MPlus.</p> Results <p>We found three distinct trajectory classes of work ability within one year after THA/ TKA: <i>no improvement</i> (24.5%), <i>delayed improvement</i> (36.6%), and <i>early improvement in work ability</i> (38.9%). Preoperative predictors for work ability trajectory classes were sex, pain intensity, functional ability in everyday life, and risk of work-related disabilities. Furthermore, work ability trajectory classes were associated with participation in the T-RENA post-rehabilitation programme, and with pain intensity one year after having started rehabilitation.</p> Conclusion <p>Despite the fact that most patients showed improvements in work ability after THA and TKA, there is a noteworthy proportion who did not. Further studies are needed to enhance identification of these individuals, and to offer targeted interventions.</p> Trial registration <p>The study is registered in the German Clinical Trials Register (DRKS00029630).</p>

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Trajectories of Work Ability After Total Hip and Knee Arthroplasty: A Latent Class Growth Analysis

  • Madeleine Gernert,
  • Michael Schuler,
  • Lea A. L. Dejonghe,
  • Andrea Schaller

摘要

Purpose

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) as treatments for osteoarthritis increasingly affect working-age adults. However, little is known about the development of work ability after THA and TKA. This study investigated different trajectory classes of work ability after THA and TKA.

Methods

This prospective study included 146 working patients (THA n = 51, TKA n = 95). They received THA/ TKA treatment as usual, including surgery, rehabilitation, and optional post-rehabilitation programmes. The primary outcome work ability was assessed five times (before surgery, end of rehabilitation, 3-month, 6-month, and 12-month follow-up) with the Work Ability Score. Additionally, the questionnaires included sociodemographic, health-, rehabilitation-, and work-related data. We applied a latent class growth analysis to identify distinct trajectory classes of work ability over 12 months, and examined associated factors using univariable multinominal logistic regression analyses in MPlus.

Results

We found three distinct trajectory classes of work ability within one year after THA/ TKA: no improvement (24.5%), delayed improvement (36.6%), and early improvement in work ability (38.9%). Preoperative predictors for work ability trajectory classes were sex, pain intensity, functional ability in everyday life, and risk of work-related disabilities. Furthermore, work ability trajectory classes were associated with participation in the T-RENA post-rehabilitation programme, and with pain intensity one year after having started rehabilitation.

Conclusion

Despite the fact that most patients showed improvements in work ability after THA and TKA, there is a noteworthy proportion who did not. Further studies are needed to enhance identification of these individuals, and to offer targeted interventions.

Trial registration

The study is registered in the German Clinical Trials Register (DRKS00029630).