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The return to professional activity patients treated surgically due to advanced gonarthrosis

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Drobniewski M., Synder M., Krasińska M., Sibiński M., Borowski A.
International Journal of Occupational Medicine and Environmental Health
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2021
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vol. 34
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issue 5
617-628
EN
ObjectivesThe goal of this work is to analyze the issue of return to professional activity by working-age patients who have been treated surgically with total knee arthroplasty (TKA) due to gonarthrosis.Material and MethodsOverall, 88 working-age patients were examined, with a total of 91 TKA procedures performed due to advanced gonarthrosis. The average age of the patients was 54.2 years for women and 58.1 years for men. A modified Knee Society Score scale was used to compile the results of the clinical trial. The Kellgren-Lawrence classification was used to assess preoperative radiographs. Postoperative radiographs evaluated the position of the endoprosthesis of both the femoral and tibial components in the anteriorposterior and lateral upright projections. The obtained results were subjected to statistical analysis.ResultsIn the preoperative assessment, both the clinical and radiological results obtained were unfavorable in all cases. Throughout the observation period of approximately over 3.8 years, a very good result was noted in 65 cases (71.4%), a good result in 20 cases (22%), and a satisfactory result in 6 cases. There were no bad results. The average improvement on the Visual Analogue Scale was 6.5 pts. The radiological assessment did not reveal any radiological symptoms of the aseptic loosening of the endoprosthesis, simultaneously concluding that each time the endoprosthesis components were properly seated. Only 53 (58.3%) of the examined patients were professionally active before the surgery. After completing the treatment, 46 (50.5%) of all patients returned to work, in favor of intellectual workers. The average duration of sick leave was 136.2 days, and rehabilitation allowance was granted in 19 cases.ConclusionsFirstly, in working-age patients, TKA is a valuable method for surgical treatment of advanced gonarthrosis of varying etiology. Secondly, most of the patients who worked before the surgery returned to performing work in the position held and on the same full-time equivalent basis.
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An assessment of the return to professional activity of patients aged ≤30 years after hip replacement surgery

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Drobniewski M., Synder M., Krasińska M., Sibiński M., Borowski A.
International Journal of Occupational Medicine and Environmental Health
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2021
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vol. 34
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issue 6
747-754
EN
ObjectivesThe study evaluated the professional activity of patients after a total cementless hip replacement surgery performed at the age of ≤30 years.Material and MethodsThe study group comprised 87 patients, with 95 total cementless hip replacements. The mean age was 25.7 years. The youngest patient was 17 years old, and the oldest 30 years old. The mean length of observation was 20.1 years, ranging 5–33 years. All patients underwent clinical and radiological evaluations before the surgery, and again in the third, sixth and twelfth months after the surgery. Further follow-up visits were performed every year. The tests were scored according to the Merle d’Aubigné and Postel (MAP) classification, as recommended by the Polish Society of Orthopaedics and Traumatology. Postoperative radiographs were used to assess the position of the endoprosthesis, and the degree of implant healing in the bone tissue. The data was subjected to statistical analysis.ResultsOf the surveyed group, 67 patients were professionally active before the surgery: 34 were white-collar workers, 29 manual workers, and 4 students or school pupils. The remaining 20 had not worked for many years, and were receiving sickness or disability benefits. An excellent result, according to the Kellgren-Lawrence classification, was noted in 22 cases, a good result in 42 cases, and a satisfactory result in 6 cases. In 25 cases, a poor result was observed. All of the patients professionally active before the surgery returned to work following the procedure. A further analysis found that 15 previously-unemployed patients commenced employment following the procedure. The mean length of the sick leave was 196.2 days, and rehabilitation payments were granted in 5 cases.ConclusionsTotal cementless hip replacement is a valuable method of treating osteoarthritis in young patients. All of the patients who worked before the surgery returned to work in the same position and on the same employment conditions. Most of the previously-unemployed patients commenced employment following the procedure.
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Hip joint arthroscopy in professionally active patients with osteoarthritis

86%
Drobniewski M., Synder M., Skrzypek M., Pstrągowski K., Polguj M., Borowski A.
International Journal of Occupational Medicine and Environmental Health
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2018
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vol. 32
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issue 1
115-120
EN
Objectives The primary endpoints of the study were to assess the effectiveness of hip joint arthroscopy in the treatment of femoroacetabular impingement (FAI) in patients with joint gap stenosis and to determine if and how quickly patients were able to return to work and physical activity. Material and Methods The prospective study of patients undergoing hip joint arthroscopy due to pain in FAI has been conducted. They were divided into 2 groups depending on the degree of the radiological examination. The criterion was the width of the joint gap. The study group involved 47 patients with hip joint gap of 2–3 mm, identified by means of the standardized X-ray examination. The control group consisted of 45 patients with hip joint gap > 3 mm. The post-operative follow-up period of the patients lasted at least 2 years. In addition, the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire together with Harris Hip Score (HHS) were applied. The patients were also evaluated for the post-operative time period enabling return to work. Results All the patients after hip joint arthroscopy returned to normal physical activity within 12 weeks after operation, enabling their return to work. However, it should be noted that during the post-operative follow-up, pain sensations either recurred or did not regress in 37 patients in the study group and 12 patients in the control group after treatment. The nearly equal results of the WOMAC questionnaire and HHS before operation significantly vary between both groups in the last follow up. In the study group they did not change expressively. Conclusions Despite the little invasiveness, hip joint arthroscopy in patients with joint gap stenosis brings about the far from satisfactory results. This procedure is not worth considering. Despite unsatisfactory pain relief, patients decided to returned to work, due to their occupational position and for fear of losing the job due to long absenteeism. Int J Occup Med Environ Health. 2019;32(1):115–20
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