title: Sick leave in Sweden before and after total joint replacement in hip and knee osteoarthritis patients.
abstract: Background and purpose - Little is know about patterns of sick leave in connection with total hip and knee joint replacement (THR and TKR) in patients with osteoarthritis (OA). Patients and methods - Using registers from southern Sweden, we identified hip and knee OA patients aged 40-59 years who had a THR or TKR in the period 2004-2012. Patients who died or started on disability pension were excluded. We included 1,307 patients with THR (46% women) and 996 patients with TKR (56% women). For the period 1 year before until 2 years after the surgery, we linked individual-level data on sick leave from the Swedish Social Insurance Agency. We created a matched reference cohort from the general population by age, birth year, and area of residence (THR: n = 4,604; TKR: n = 3,425). The mean number of days on sick leave and the proportion (%) on sick leave 12 and 24 months before and after surgery were calculated. Results - The month after surgery, about 90% of patients in both cohorts were on sick leave. At the two-year follow-up, sick leave was lower for both cohorts than 1 year before surgery, except for men with THR, but about 9% of the THR patients and 12-17% of the TKR patients were still sick-listed. In the matched reference cohorts, sick leave was constant at around 4-7% during the entire study period. Interpretation - A long period of sick leave is common after total joint replacement, especially after TKR. There is a need for better knowledge on how workplace adjustments and rehabilitation can facilitate the return to work and can postpone surgery.
authors.affiliation: a Department of Health Sciences, Faculty of Medicine , Lund University , Lund.|b Epidemiology and Register Center South, Skåne University Hospital, Region Skåne , Lund.
authors.forename: Kjerstin
authors.initials: K
authors.lastname: Stigmar
authors.affiliation: c Department of Clinical Sciences Lund, Orthopedics, Faculty of Medicine , Lund University, and Clinical Epidemiology Unit , Lund , Sweden.
authors.forename: Leif E
authors.initials: LE
authors.lastname: Dahlberg
authors.affiliation: b Epidemiology and Register Center South, Skåne University Hospital, Region Skåne , Lund.
authors.forename: Caddie
authors.initials: C
authors.lastname: Zhou
authors.affiliation: c Department of Clinical Sciences Lund, Orthopedics, Faculty of Medicine , Lund University, and Clinical Epidemiology Unit , Lund , Sweden.
authors.forename: Helena
authors.initials: H
authors.lastname: Jacobson Lidgren
authors.affiliation: b Epidemiology and Register Center South, Skåne University Hospital, Region Skåne , Lund.|c Department of Clinical Sciences Lund, Orthopedics, Faculty of Medicine , Lund University, and Clinical Epidemiology Unit , Lund , Sweden.
authors.forename: Ingemar F
authors.initials: IF
authors.lastname: Petersson
authors.affiliation: b Epidemiology and Register Center South, Skåne University Hospital, Region Skåne , Lund.|c Department of Clinical Sciences Lund, Orthopedics, Faculty of Medicine , Lund University, and Clinical Epidemiology Unit , Lund , Sweden.|d Clinical Epidemiology Research and Training Unit, Boston University School of Medicine , Boston , MA , USA .
authors.forename: Martin
authors.initials: M
authors.lastname: Englund
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016247:Information Storage and Retrieval; D018868:Insurance, Disability; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000601:surgery*; D011184:Postoperative Period; D057234:Preoperative Period; D012737:Sex Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D012943:Social Security; D013548:Sweden