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Return to Work after Surgical Treatment of Coxarthrosis by Total Cementless Hip Arthroplasty.

BACKGROUND
Total hip arthroplasty is currently commonly used in surgical treatment of advanced hip osteoarthritis of various aetiologies. Studies show that the number of these procedures has been growing every year, which is associated with global population ageing. The aim of the study was to assess return to work in patients after surgical treatment by arthroplasty due to hip osteoarthritis.


MATERIAL AND METHODS
The study assessed 114 patients of productive age who underwent surgery due to advanced hip osteoarthritis. The mean age was 49.9 years in women and 52.2 years in men. All patients included in this retrospective study underwent clinical and radiographic assessment prior to arthroplasty and at the last out-patient follow-up visit. The patients' occupational status and the time of return to work after surgery were also assessed. The results of this clinical study were analysed according to the Merle d'Aubigne-Postel classification (modified by Charnley). Preoperative radiographs were assessed according to the Kellgren-Lawrence classification. The radiographs served to assess the position of the endoprosthesis, including both the acetabular component and the stem. The results were statistically analysed.


RESULTS
Pre-operative assessment classified all cases as poor both clinically and radiographically. The post-operative outcomes were excellent in 71 cases (61.7%), good in 37 cases (32.2%) and fair in 7 cases. No case was classified as poor. The mean improvement was 6.6 points and reached the level of statistical significance. Radiographic evaluation did not reveal evidence of aseptic implant loosening and confirmed a normal seat of endoprosthetic components within the Lewinnek safe zone in each case. Only 75 (65.8%) of the study participants worked before the procedure. After the treatment was completed, 67 (58.8%) study patients took up employment. The mean duration of sick leave was 138.6 days and 21 patients were receiving rehabilitation benefits.


CONCLUSIONS
1. Total hip arthroplasty is a valuable method of surgical treatment of advanced coxarthrosis of various aetiologies in patients of productive age. 2. Most patients who worked before the surgery return to work in the same position and work time. 3. Only dysplastic coxarthro-ses have an unfavourable prognosis with respect to starting or resuming work after surgery.