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Most patients back at work after knee replacement

Obesity alone doesn’t raise complication rates – but hospital stays are longer

Louise Prime

Thursday, 21 March 2013

Most people who were working before they had total knee replacement (TKR) surgery returned to work afterwards, US research has shown. The study, being presented today at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), showed that 98% of those in heavy jobs were back at work after recovery.

US researchers analysed data, collected by an independent company, on 661 people aged 18-60 one to five years after they had undergone TKR surgery. About three-quarters (74.6%) had been employed during the three months before their surgery. Men were significantly more likely than women to return to work (82.3% vs. 73.7%).

Overall, 91.1% of patients had returned to work after surgery, of whom 93.3% had successfully returned to their old job. Of those who had previously been in sedentary work, 92.3% had returned to work; 79.2% of those in light work had gone back; and for medium, heavy and very heavy work the proportions were 89.0%, 87.8% and 78.2%.

The authors said: “When pain and suffering from end-stage degenerative joint disease of the knee compromises a patient’s ability to maintain gainful employment, [TKR] is successful in keeping the patient in the work force. Returning patients back to work not only gives the patient a sense of fulfilment, but also is economically beneficial to our society.”

A separate study also being presented today at the AAOS meeting showed that obesity alone did not affect the 90-day complication rate for TKR surgery. However, it was associated with longer hospital stays and higher costs.

Researchers reviewed 8129 patients’ records, and compared clinical and surgical characteristics, complications and hospital costs between patients with various comorbidities and body mass index (BMI).

They found that increasing BMI was not associated with a higher risk of complications but it was associated with significantly longer hospital stays, after adjusting for age, sex, type of surgery and comorbidities. They said: “In analyses restricted to patients with no comorbidities, the association with BMI was not significant, suggesting that the impact of obesity on costs was mediated largely through increased prevalence of comorbidities.”

They concluded: “In TKA, obesity does not seem to increase the overall risk of 90-day complications, but it is associated with longer hospital stays and costs. The effect of obesity is in part mediated through obesity-related comorbid conditions.”

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