Does Physical Job Intensity Affect Return to Work and Satisfaction Rates Following Primary Total Hip Arthroplasty?

Patients' satisfaction and job limitations after primary total hip arthroplasty (THA) based on occupation intensity have not been evaluated. This study aimed to assess patients' ability and satisfaction with their return to work following primary THA depending on intensity of their occupation.

This retrospective review surveyed patients undergoing primary THA between June 2011 and January 2022, with at least one year of follow-up, on return to work rates. Of 1,713 participants, 1,176 (68.7%) reported working prior to THA and were stratified into high intensity (HI) (i.e. laborer, construction), standard intensity (SI) (i.e. walking, climbing stairs), and low intensity (LI) (i.e. desk jobs) groups. Baseline demographics and survey responses were compared. Among patients who worked preoperatively, 66 (5.6%), 450 (38.3%), and 660 (56.1%) were in the HI, SI, and LI groups, respectively.

High rates of workers across all groups reported improvements in their ability to work following THA, with 74.8% of SI, 68.8% of LI workers and 63.6% of HI workers reporting "remarkable" or "modest improvement." The HI group was more likely male, younger, and a current smoker compared to the SI and LI groups. Among LI workers, 47.2% returned within the first month and83.6% returned within two months. SI workers showed a similar pattern, with 36.2% returning in less than a month and 79.7% returning within two months. HI workers had a comparatively lower return rate, with 12.3% returning within the first month and 52.6% returning within two months.

Across all intensity levels, THA enables improvements in perceived work function and satisfaction. However, higher-intensity work requires more time, is more difficult, and yields lower return-to-work satisfaction compared to low-intensity work.