¹Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
²Department of Physiotherapy, Rehabilitation Centre, Ryhov County Hospital, Jönköping, Sweden
³Department of Public Health and Clinical Medicine, Umeå, Sweden
⁴Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
⁵Department of Diagnostics and Intervention, Section of Orthopedics, Umeå, Sweden
⁶Department of Public and Occupational Health Amsterdam UMC, Amsterdam, Netherlands
⁷Department of Epidemiology and Global Health, Umeå, Sweden

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Introduction: As the prevalence of hip- and knee osteoarthritis increases, so does the number of replacement surgeries among working-age individuals, leading to a heightened need for sick leave. This study aims to describe sick leave patterns before and after hip and knee replacement surgeries in a national Swedish population and to compare these patterns with a matched sample from the general Swedish population.

Methods: This longitudinal observational register-based study included a national cohort of patients aged 18 and 69 years who received hip or knee replacement due to osteoarthritis between 2012 and 2022, as recorded in the Swedish Arthroplasty Register. Data on all-cause sick leave were obtained from the Swedish Social Insurance Agency for the 12 months prior to surgery and the 24 months following surgery. Patients were matched by sex, age, and residence with a sample from the general Swedish population at the time of their first registration in the Arthroplasty Register. Descriptive analyses and mixed-model comparisons were used to compare sick leave rates between the surgical cases and the controls.

Results: We identified 64 420 patients who received hip replacement and 60 758 who received knee replacement. The median age of patients with hip surgery was 62.0 years (IQR 56 to 66), with 52% being women. For knee surgery patients, the median age was 63.0 years (IQR 58 to 66), with 55% being women. Patients who received hip replacement had significantly more days of sick leave before surgery compared to their controls (mean 30 days vs. 10 days, p<0.001). This trend continued after surgery (mean 77 days vs. 18 days, p<0.001). Similar patterns were observed in patients undergoing knee replacement (mean 35 days vs. 11 days before surgery [p<0.001] and mean 96 days vs. 19 days after surgery [p<0.001]).

Discussion: The increasing demand for sick leave due to the rising number of replacement surgeries for osteoarthritis will also result in a growing number of individuals needing to be able to return to work after surgery, impacting both individuals and society. These initial analyses are part of a larger project aimed at examining sick leave patterns associated with hip and knee replacement surgeries within the national Swedish population and identifying factors that influence return to work. Future analyses will explore how various factors such as sex differences, physical workload and type of healthcare provider affect return to work after hip and knee replacement surgery.

Conclusion: Prolonged periods of sick leave are common before and after knee and hip replacement surgery. Patients who have undergone surgery, particularly those who have undergone a knee replacement, being on sick leave to a much greater extent than the general working population.