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Original research
Feasibility and sustainability of working in different types of jobs after total hip arthroplasty: analysis of longitudinal data from two cohorts
  1. Elena Zaballa1,2,
  2. Georgia Ntani1,2,
  3. E Clare Harris1,2,
  4. Anne Lübbeke3,4,
  5. Nigel K Arden1,4,
  6. Didier Hannouche3,
  7. Cyrus Cooper1,5,
  8. Karen Walker-Bone1,2
  1. 1MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
  2. 2MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
  3. 3Division of Orthopaedic Surgery and Traumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
  4. 4Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
  5. 5NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
  1. Correspondence to Elena Zaballa, MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK; ez{at}mrc.soton.ac.uk

Abstract

Objectives To investigate the rates of return to work and workability among working-age people following total hip arthroplasty (THA).

Methods Participants from the Geneva Arthroplasty Registry and the Clinical Outcomes for Arthroplasty Study aged 18–64 years when they had primary THA and with at least 5 years’ follow-up were mailed a questionnaire 2017–2019. Information was collected about preoperative and post-THA employment along with exposure to physically demanding activities at work or in leisure. Patterns of change of job were explored. Survival analyses using Cox proportional hazard models were created to explore risk factors for having to stop work because of difficulties with the replaced hip.

Results In total, 825 returned a questionnaire (response 58%), 392 (48%) men, mean age 58 years, median follow-up 7.5 years post-THA. The majority (93%) of those who worked preoperatively returned to work, mostly in the same sector but higher rates of non-return (36%–41%) were seen among process, plant and machine operatives and workers in elementary occupations. 7% reported subsequently leaving work because of their replaced hip and the risk of this was strongly associated with: standing >4 hours/day (HR 3.81, 95% CI 1.62 to 8.96); kneeling/squatting (HR 3.32, 95% CI 1.46 to 7.55) and/or carrying/lifting ≥10 kg (HR 5.43, 95% CI 2.29 to 12.88).

Conclusions It may be more difficult to return to some (particularly physically demanding) jobs post-THA than others. Rehabilitation may need to be targeted to these types of workers or it may be that redeployment or job change counselling are required.

  • epidemiology
  • occupational health
  • longitudinal studies
  • osteoarthritis
  • exercise

Data availability statement

Data are available on reasonable request. The dataset containing occupational and leisure information on the Clinical Outcomes in Arthroplasty Study is subject to MRC confidentiality and data sharing regulations. Researchers requesting access to the data may contact KWB (kwb@mrc.soton.ac.uk) and NKA (nigel.arden@ndorms.ox.ac.uk). Researchers requesting access to Geneva Arthroplasty Registry data may contact AL (anne.lubbekewolff@hcuge.ch).

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Data availability statement

Data are available on reasonable request. The dataset containing occupational and leisure information on the Clinical Outcomes in Arthroplasty Study is subject to MRC confidentiality and data sharing regulations. Researchers requesting access to the data may contact KWB (kwb@mrc.soton.ac.uk) and NKA (nigel.arden@ndorms.ox.ac.uk). Researchers requesting access to Geneva Arthroplasty Registry data may contact AL (anne.lubbekewolff@hcuge.ch).

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Footnotes

  • Contributors KWB, GN, ECH and EZ contributed to the conception and design of the study. GN and EZ conducted the statistical analyses. EZ wrote the first draft of the manuscript, and all the authors revised critically the manuscript and approved the final version. KWB is responsible for the overall content of this study.

  • Funding This study was funded by MRC versus Arthritis (formerly Arthritis Research UK) Centre for Musculoskeletal Health and Work award (ref 22090).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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