Return to work following total hip arthroplasty: a Japanese retrospective cohort study highlighting the impact on satisfaction and life purpose

Abstract

This study investigated return to work (RTW) patterns following total hip arthroplasty (THA), focusing on factors influencing RTW, RTW timing, and the relationship between postoperative employment and patient-reported outcome measures (PROMs). This retrospective cohort study included 310 patients who underwent THA between 2012 and 2016 in Japan. Mailed surveys assessed employment status, occupation type, RTW timing, and PROMs, including the Oxford Hip Score, Forgotten Joint Score-12, visual analog scale (VAS) for satisfaction, and Ikigai-9 for life purpose. Regression analyses were performed to identify predictive factors. Employment rates were 55% preoperatively and 45% postoperatively, with an overall RTW rate of 81%. Younger age (≤ 62 years) significantly predicted RTW (odds ratio, 0.94; p < 0.01). Among those returning to work, 66% did so within 3 months. Sedentary workers had a significantly higher RTW rate within 1 month (40.8%, p = 0.022), however, overall RTW rates did not differ significantly across occupational categories (p = 0.590). Anxiety about dislocation was the most common reason for delayed RTW. Postoperative employment significantly correlated with higher VAS satisfaction (β = 2.31, p = 0.01) and Ikigai-9 scores (β = 1.28, p < 0.01). The RTW rate was 81%, with higher rates in younger age. Sedentary work was associated with earlier RTW. Addressing anxiety about dislocation through appropriate education and rehabilitation may facilitate RTW after THA. Postoperative employment was linked to higher satisfaction and Ikigai for life purpose. Communicating these findings may improve patient RTW rates, satisfaction, and overall well-being.