Occupational activity following total knee replacement surgery

Lead Investigator: Karen Walker-Bone
Co-Investigators: Nigel Arden,  David Coggon, Cyrus Cooper, Clare Harris, Kassim Javaid, Cathy Linaker, Philip Chapman-Sheath
Funders: Arthritis Research-UK
Knee replacement (arthroplasty) is a very successful treatment for severe osteoarthritis. In England, it is now performed on 60,000 patients per year but as experience with the procedure grows, it is increasingly offered to people at younger ages. Now that state pension age is rising and the default age for retirement has been abolished, more people are working to an older age. As a consequence of these trends, knee replacement among people who are still working will become more frequent. The risks of knee osteoarthritis and injury are increased by some occupational activities (e.g. heavy lifting, prolonged kneeling or squatting. It is not clear, however, whether returning to occupations involving such exposures will carry an increased risk of joint failure or complications over the long term, and there is currently no evidence on which to base recommendations to patients on occupational activities that can safely be undertaken following knee arthroplasty.

Main Research Question:
(1) Is the risk of post-operative joint failure or complications (including knee pain) increased by return to work involving heavy physical workplace activities?

Study design:
The study will focus on people who underwent knee arthroplasty between 1st April 1999 and 31st March 2003 when they were aged <60 years and whose discharge diagnosis did not include major trauma or inflammatory arthritis. Eligible participants will be identified from Hospital Episode Statistics (HES), a database which covers all such operations in English NHS hospitals. They will be sent a postal questionnaire via their surgeon (by use of codes, this can be done without the identity of the patient being revealed to the research team). The questionnaire will collect information about symptoms, function and occupational activities during the time since surgery, and this will be analysed to answer the study question.

to follow