P-604 Three Clinically Meaningful Recovery Trajectories for Work-Related Activities Among Total Knee Arthroplasty Patients. A 12 Months Multicenter Prospective Cohort Study

Introduction Total Knee Arthroplasty (TKA) is increasingly performed on working patients, but only 65% return to work (RTW). This study aims to identify recovery trajectories for performing work-related activities and their association with time to RTW. Methods A multicenter prospective cohort study was performed among working TKA patients. The Work Osteoarthritis or Joint-Replacement Questionnaire (WORQ) was used to assess the difficulty in performing work-related activities (0-100 scale, minimal clinically important change MIC=13). Trajectories were based on the 3-month postoperative WORQ score, using the three-part classification of scores for early (≥71), moderate (71 - 50) and late (≤ 50) recovery trajectory. Changes between preoperative and postoperative WORQ scores at 3, 6 and 12 months were calculated for each trajectory. Kaplan-Meier curves were used to analyze time to RTW for each trajectory. Results Among 182 working TKA patients, three recovery trajectories emerged: early (n=54), moderate (n=68), and late (n=60). The MIC was reached at 3 and 6 months for early and moderate recovery trajectories, but not for the late trajectory. Patients with early recovery returned to work significantly faster (Median 62 [IQR 41-90]) than those with moderate (75 [46-115]) or late (84 [58-116]) recovery. Discussion This study confirms early, moderate, and late recovery trajectories for work-related activities and RTW in working TKA patients, highlighting the potential for early detection of late recovery. Conclusion WORQ scores at 3 months postoperative can effectively distinguish patients experiencing late recovery in work-related activities, leading to a delayed RTW.