Does Knee Arthroplasty Have a Beneficial Effect on Return to Work in Patients with Knee Osteoarthritis who Receive Long-Term Disability Benefits in the Netherlands?
Titi J Cheng, Karen Nieuwenhuijsen, P Paul F M Kuijer
PMID 39256255WHAT IT FOUND
For patients on long-term disability benefits due to knee osteoarthritis, knee replacement surgery did not improve the chance of returning to paid work over ten years.
Being a household breadwinner helped return to work, while being classified with 100% disability hindered it.
Key findings
01Knee arthroplasty was not significantly associated with returning to paid work in patients receiving long-term disability benefits for knee osteoarthritis.
02Being the main household breadwinner at the start of disability benefits was strongly associated with a higher likelihood of returning to paid work.
03Being assigned 100% work disability status at the start of benefits was associated with a significantly lower likelihood of returning to paid work.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study only included people who had already been on disability benefits for at least two years, so the results do not apply to patients who are newly sick-listed or considering surgery earlier. The response rate was low (30% of invitees), and it is unknown why others did not participate, which may introduce selection bias. Participants self-reported whether they had surgery and returned to work, though the authors argue these are major events unlikely to be misremembered. The study could not distinguish between different types of knee replacement (total vs. partial) or revision surgeries. Results are specific to the Dutch disability system, which has unique financial incentives and rules for partial versus full disability, limiting generalizability to other countries.
Declared interests
The study was funded by the Research Center for Insurance Medicine (KCVG) in Amsterdam. No other conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that knee replacement is ineffective for improving function or pain. This study only looked at return to paid work in patients who had already been on long-term disability for at least two years. It does not address whether surgery helps patients who are still employed or newly off work.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →