title: Patient-reported factors influencing return to work after joint replacement.
abstract: BACKGROUND
  An increasing number of patients in the working population are undergoing total hip and knee replacement for osteoarthritis and the timing and success of return to work (RTW) is becoming increasingly important as a measure of success for these patients. There is limited understanding of the patient variables that determine the ability to RTW.
  
  
  OBJECTIVE
  To explore the factors influencing RTW following hip and knee replacement from the patient's perspective.
  
  
  METHODS
  A cross-sectional population-based postal survey carried out with patients of working age after hip and knee replacement surgery in a UK teaching hospital. Free text comments were collected regarding the experiences of patients returning to work following hip and knee replacement. Qualitative thematic analysis was undertaken to identify the factors influencing RTW from the patient's perspective.
  
  
  RESULTS
  From the patients' perspective three key factors were identified that influenced RTW. Patients reported an improved physical and psychological performance at work after surgery in comparison to pre-operative functioning, although there was a lack of informed advice regarding RTW after surgery. Workplace support and adaptation of the job role enhanced the experience of RTW.
  
  
  CONCLUSIONS
  Return to work is influenced by a combination of patient, clinician and occupational factors. The relationship between each of these needs to be explored in greater depth through further qualitative work to gain a wider understanding of the variables influencing patients' RTW following hip and knee replacement.
authors.affiliation: Department of Orthopaedic Surgery, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK, michelle.bardgett@nuth.nhs.uk.
authors.forename: M
authors.initials: M
authors.lastname: Bardgett
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
authors.forename: J
authors.initials: J
authors.lastname: Lally
authors.affiliation: Department of Orthopaedic Surgery, Northumbria Healthcare NHS Foundation Trust, Tyne and Wear NE29 8NH, UK.
authors.forename: A
authors.initials: A
authors.lastname: Malviya
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
authors.forename: B
authors.initials: B
authors.lastname: Kleim
authors.affiliation: Department of Orthopaedic Surgery, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK.
authors.forename: D
authors.initials: D
authors.lastname: Deehan
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000523:psychology / Q000534:rehabilitation / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D016272:Occupational Health; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D036301:Qualitative Research; D020127:Recovery of Function; D062707:Return to Work / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D017132:Workplace
keywords: Qualitative; return to work; total hip replacement; total knee replacement.