Return to work after total ankle replacement

An increasing number of patients in the working population are undergoing total ankle replacement (TAR) for end-stage osteoarthritis. While improvements in pain and functional outcomes are the primary goals of this procedure, the timeline for return to work significantly factors into the measure of success for these patients. The aim of this study was to establish the time required before patients return to work after TAR.

A retrospective review of TARs performed between January 2019 and January 2024 was performed. Patients undergoing primary TAR, less than 65 years old, employed or actively participating in a full-time position, and minimum 6 months of follow-up were included. Exclusion criteria were prior ankle arthrodesis, active Workers' Compensation patients, and those undergoing treatment for psychological disease. The primary outcome measure was time to return to work following TAR. Secondary measures included demographic data, patient reported outcomes, and rates of reoperation and revision.

Fifty-three patients met inclusion and exclusion criteria. The mean time to return to sedentary work was 2.73 weeks (SD = 1.03), and the return to laborious work was 13.15 weeks (SD = 3.51). Five patients retired or reduced their role after TAR (9.4 %). Mean follow-up was 22.9 months (SD = 11.0, median = 25). Significant improvement was noted in patient outcome scores post-operatively. A total of 10 complications occurred with no revision TAR required at this short-term follow-up.

The majority of patients employed before TAR return to work post-operatively. Manual labor workers required an average of over 4 times longer to resume work.