14– 17 Currently, > 1 million hip and knee replacements are carried out annually in the USA and > 190,000 are carried out annually in England, Wales and Northern Ireland. Lower limb joint replacements are successful and cost-effective treatments that relieve pain, restore physical function and improve health-related quality of life for patients with hip and knee arthritis.
The role of lower limb joint replacement in patients of working age 12, 13 Therefore, earlier return to work (RTW) has potential health benefits as well as socioeconomic benefits. 9– 11 Loss of employment is associated with a reduction in physical function, increased anxiety and depression and increased risk of mortality. In addition to its financial benefits, working has significant physical, mental and emotional health benefits. 7, 8 However, these figures do not take account of non-work-related injuries and ill health and, therefore, are likely to be an underestimate of the total cost. 7, 8 The Health and Safety Executive estimates that the total annual cost of workplace ill health due to musculoskeletal disorders is £9.7B, equivalent to £18,400 per case. 6, 7 The Health and Safety Executive calculates the annual cost of workplace injury and ill health on this basis by estimating both the financial cost and the ‘human’ cost. Direct (the cost of treatment) and indirect (costs related to the impact of the period of ill health) costs are borne by the individual (impact of ill health on quality of life), employers and society (loss of productivity, need for health care, rehabilitation and compensation). The cost of work-related musculoskeletal disorders that have an impact on a person’s ability to work is difficult to quantify. The highest rates of disability retirement in men were found in construction workers, electricians and plumbers, and in women they were found in building caretakers, cleaners, nurses and kitchen workers. 5 found that the age-adjusted incidence of disability retirement owing to knee osteoarthritis was 60 and 72 per 100,000 person-years for men and women, respectively. 3, 4 In a national study of patients in Finland, Kontio et al. 2 A diagnosis of hip or knee osteoarthritis is associated with a reduction in work participation and productivity and an increased risk of work loss. 1 The magnitude of the impact varies according to the degree of activity limitation and disease severity. Chapter 1 Background and study introduction Is there a need for an occupational advice intervention for hip and knee replacement patients? The impact of hip and knee osteoarthritis on employmentĭecreased physical function associated with hip and knee osteoarthritis reduces the likelihood of employment, reduces household income and increases the number of missed workdays for those who are employed.