Introduction Total knee arthroplasty (TKA) is increasingly being performed among working patients suffering from knee osteoarthritis. As the retirement age is rising and more workers are being overweight or obese, a further increase is expected in the upcoming decade. Unfortunately, limited disorder-specific evidence is available for clinicians to support these patients in return to work (RTW). This semi-plenary provides an interactive overview, using quiz-questions, of what we know now and how to guide these workers to secure a timely and sustainable RTW.

Methods Questions that will be addressed are: how many patients do RTW after TKA?, which TKA patients should be referred to work-directed care?, which work-related knee-demanding activities improve most after TKA?, what do workers expect from TKA before surgery?, do orthopaedic surgeons and occupational physicians provide the same answers regarding prognosis for RTW?, and what kind of vocational rehabilitation is effective for RTW?.

Result Two quiz-questions are already answered.

First, based on a systematic review, 71%–83% of TKA patients in working age returned to work: so 2 to 3 out of 10 did not. The average time varied from 8 to 12 weeks although large differences were noted. Second, the Work, Osteoarthritis or joint-Replacement Questionnaire (WORQ) was used to assess the self-perceived difficulty performing 13 work-related knee demanding activities like kneeling, lifting, and working with hands below knee height. Patients who benefitted most from TKA are those whose work involved operating a vehicle or who have a job which requires periods of standing or walking on level ground.

Discussion In the upcoming decade, more TKA patients will have to RTW after surgery, and expect sound advice and guidance from their physician. Given the limited evidence available and the large group of workers involved, effective interventions to secure a timely and sustainable RTW should be developed.