Return to Work after Knee Replacement – Timeline and Challenges Written by Dr. Brian Hatten M.D. on Wednesday, 02 September 2015

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Knee replacement surgery is being performed at earlier ages than ever before due to a combination of better surgical techniques, improved implant design, and increased patient demand. In the past, most orthopedic surgeons would have been very hesitant to perform this operation on someone in their 50's. Now this has become common place.

Surgery on younger patients with severe arthritis means that there are more people who are still actively working when they have their procedure performed. Knee replacement is no longer a surgery reserved for a retired person.

We have developed this two part blog to help answer: "When will I be able to return to work after my knee replacement surgery and what are the particular challenges faced?" This first installment of the blog provides the general framework to help each patient formulate their own return to work plan. The second blog installment (entitiled: "Return to Work after Knee Replacement – Patients Perspectives") details the stories of how several patients overcame these challenges.

The time a knee replacement patient can return to work varies not only by the individual, but also by the type of profession. Patients employed in sedentary jobs may be able to return to work when they can safely travel to and from their job, generally between 2 to 6 weeks. These patients are advised to elevate the operated leg when possible and get up and walk around at appropriate intervals. For light-duty jobs that require more standing and walking, patients may return when they can walk without a limp, generally between 6 to 12 weeks. For heavy demand jobs, patients may be able to return to work between 10 to 12 weeks, when they are capable of safely performing their job requirements. ¹

One particular study found that found that patients who return to work within one month of surgery tend to report more pain, function and work limitations than those who return later post-surgery. Interestingly, age was not necessarily associated with the time by which individuals returned to work. The study confirmed that the patient's particular work demands influenced the time to return to work. People working in business, finance and administration and with low physical demand work were at least twice as likely to return to work earlier than patients with more demanding work requirements. This study also found that the limitations experienced at work were not purely physical but also included limitations in concentration, meeting job demands and transportation to and from work. ²

In a separate study of 660 knee replacement patients, ninety eight percent (98%) of patients were able to return to work after surgery. Of these patients, eighty nine percent (89%) successfully returned to the job they had prior to surgery. Patients working in very heavy jobs required the most time off for recovery, an average of eleven (11) weeks. However, those employed in sedentary positions averaged only seven (7) weeks for recovery. In this study there was no difference between male or female patients in either the percentage who returned to work or in time off work required for recovery after surgery. ¹

Those patients with sedentary occupations had the highest rate of return to their usual work, ninety seven percent (97%) of the time. Those with very heavy demand jobs returned to their same job eighty eight percent (88%) of the time. For purposes of planning for expenses, leave time, and job coverage, the average time off work was 2 months overall and 2.5 months for workers in very heavy demand jobs. ¹

Since ninety eight percent (98%) of patients are able to return to work after surgery, the total cost to society for treatment of severe knee osteoarthritis is markedly lower when patients undergo total knee arthroplasty rather than non-operative treatment. Of course this doesn’t mean that everyone with arthritis needs a knee replacement. However, when surgery is indicated, the studies show that early intervention with total knee arthroplasty is beneficial not only on the individual level but also to society at large. ³

There have been research models that have found that the lifetime societal net benefit for each patient undergoing knee replacement averages between $10,000 – $30,000. Eighty five percent (85%) of these savings originated from increased income, through a combination of increased probability of working and higher earnings. The remaining fifteen percent (15%) of societal savings came from indirect costs such as fewer missed work days and lower disability payments. ⁴

The decision to proceed with surgical managmenent is frequently complex and the time necessary for recovery from surgery varies from patient to patient. As we have outlined, the typical schedule for returning to work will also depend on the type of work needed to be performed. Our second installment of this blog focusses on the real life experiences of several patients who share their struggles and provide tips for retuning back to work after knee replacment surgery.