Purpose This study compared the preoperative levels and postoperative recovery courses of physical and mental impairments, activity limitations and participation restrictions of working-age patients who return to work (RTW) by 3, 6 or 12 months after total knee arthroplasty (TKA). Methods A prospective survey study including TKA patients (aged < 65) (n = 146) who returned to work (RdTW) in the first postoperative year. Three groups were compared: those who returned by 3 (n = 35), 6 (n = 40) or 12 (n = 29) months. Surveys were completed preoperatively and at 6 weeks and 3, 6 and 12 months postoperatively. Outcomes represented domains of the International Classification of Functioning, i.e. physical impairments (pain, stiffness, vitality), mental impairments (mental health and depressive symptoms), activity limitations (physical functioning) and participation restrictions (social and work functioning). Results Preoperative knee-specific pain and physical functioning levels were better among patients who RdTW by 3 months, compared to those who returned by 12 months. Patients who RdTW by 3 months experienced significantly better recovery from physical impairments than those who returned by 6 months (on general pain) or 12 months (on general and knee-specific pain and on stiffness). Patients returning by 3 months experienced significantly better recovery from activity limitations (on knee-specific physical functioning). Conclusions To optimize return to work outcome after TKA surgery, the focus should lie on physical impairments (general and knee-specific pain, stiffness) and activity limitations (knee-specific physical functioning) during recovery.

目的本研究比较了全膝关节置换术（TKA）后3、6或12个月恢复工作（RTW）的工作年龄患者的身心障碍、活动受限和参与受限的术前水平和术后恢复过程。方法一项前瞻性调查研究，包括在术后第一年恢复工作 (RdTW) 的 TKA 患者（年龄 < 65）（n = 146）。比较了三组：那些在 3 (n = 35)、6 (n = 40) 或 12 (n = 29) 个月前返回的组。调查在术前和术后 6 周、3、6 和 12 个月完成。结果代表了国际功能分类的领域，即身体损伤（疼痛、僵硬、活力）、精神损伤（心理健康和抑郁症状）、活动受限（身体功能）和参与限制（社交和工作功能）。结果与 12 个月前恢复的患者相比，3 个月前 RdTW 患者的术前膝关节特异性疼痛和身体功能水平更好。与 6 个月（全身疼痛）或 12 个月（全身和膝关节特异性疼痛以及僵硬）相比，3 个月前 RdTW 的患者从身体损伤中恢复得更好。3 个月后返回的患者从活动受限（膝关节特定的身体功能）中恢复得更好。结论为了优化 TKA 术后恢复工作的结果，重点应放在恢复期间的身体损伤（全身和膝关节特异性疼痛、僵硬）和活动受限（膝关节特异性身体功能）。