Purpose
This study evaluated the hypothesis that higher occupational hand force requirements
are related to slower return to work (RTW) after surgery for trapeziometacarpal joint
osteoarthritis.
Methods
Patients treated surgically for trapeziometacarpal joint osteoarthritis from 2001
to 2017 were identified in the Danish National Patient Register. Sustainable RTW (sRTW)
was defined as the first period of 4 consecutive weeks without health-related public
transfer payments, according to the Danish National Register on Public Transfer Payments.
Occupational codes from the Danish Employment Classification Module were linked to
a hand-arm job exposure matrix to obtain occupational hand force requirements for
each patient. Cox regression models were used to analyze time until sRTW in relation
to hand force requirements with adjustment for age, sex, type of surgery, preoperative
sick leave, and calendar year of surgery.
Results
The study included 2,090 patients. Within 104 weeks, 91% sustainably returned to work.
The percentage of individuals in the subgroups that did not RTW was 8% of low-force−
and medium-force−exposed patients and 14% of high-force-exposed patients. Medium and
high occupational hand force requirements were associated with slower sRTW. The adjusted
hazard ratio for sRTW was 0.84 (95% confidence interval, 0.74–0.95) for medium and
0.59 (95% confidence interval, 0.50–0.68) for high compared with low hand force requirements.
Among patients who returned to work, patients with medium and high hand force requirements
had median periods until sRTW of 16 and 18 weeks, respectively, compared with 10 weeks
among patients with low hand force requirements.
Conclusions
The prognosis regarding RTW after surgery for trapeziometacarpal joint osteoarthritis
is generally good, but patients with higher occupational hand force requirements can
expect slower RTW.
Type of study/level of evidence
Prognostic II.
Key words
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Article info
Publication history
Published online: February 09, 2023
Accepted:
December 20,
2022
Received:
March 26,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly to this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
