DOS 2018

DOS Kongressen 2018 · 109 Influence of occupational mechanical exposures on return to work and disability after trapeziometacarpal total joint arthroplasty Lone Kirkeby, Poul Frost, Susanne Wulff Svendsen, Torben Bæk Hansen University Clinic of Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Holstebro; Danish Ramazzini Centre, Department of Occupational Medicine , Aarhus University Hospital, Aarhus; Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland - University Research Clinic, Herning Background: There are no published studies concerning return to work and disability after trapeziometacarpal (TM) total joint arthroplasty in patients of working age. Purpose / Aim of Study: To determine the influence of occupational mechani- cal exposures on the prognosis after TM total joint arthroplasty with respect to return to work and patient-rated disability, hypothesizing that occupational mechanical exposures are negative prognostic factors. Materials and Methods: The study is a register- and questionnaire based fol- low-up study of 239 patients aged 39-65 years (mean age 55 years), who were operated with a TM total joint arthroplasty in the period 2003-2015. Data concerning DASH, VAS and grip strength before the operation and 3 and 12 months postoperatively was combined with information about labour mar- ket attachment from the Danish National Register on Public Transfer Payments. The patients’ self- reported job title was linked to a job exposure matrix to ob- tain estimates of occupational mechanical hand-arm exposures. Uni- and multi- variable Cox and Poisson regression models were used. Findings / Results: A high DASH score before operation was associated with less chance of clinical relevant improvement in DASH 12 months after surgery. 127 patients were listed as active on the labour market at the time of surgery. Of these, 49% returned to work within 15 weeks, and 12 months after surgery 91% had returned. Forceful work was a predictor of later return to work. Conclusions: The prognosis after TM total joint arthroplasty with respect to return to work and disability is generally good. High occupational mechanical exposures are associated with prolonged sick leave. Knowledge of the patient’s occupational exposures is necessary for conveying realistic expectations re- garding the time needed off work postoperatively. 50.