Presenteeism and Absenteeism Before and After Total Hip and Knee Arthroplasty

Abstract Background Absenteeism is costly, yet evidence suggests that presenteeism—illness-related reduced productivity at work—is costlier. We quantified employed patients’ presenteeism and absenteeism before and after TJA. Methods We measured presenteeism (0-100 scale, 100 full performance) and absenteeism using the World Health Organization’s Health and Work Performance Questionnaire before and after TJA among a convenience sample of employed patients. We captured detailed information about employment and job characteristics and evaluated how and among whom presenteeism and absenteeism improved. Results 636 primary, unilateral TJA patients responded to an enrollment email, confirmed employment, and completed a pre-operative survey (mean age: 62.1, 55.3% female). Full at-work performance was reported by 19.7%. Among 520 (81.8%) who responded to a one-year follow-up, 473 (91.0%) were still employed, and 461 (88.7%) had resumed working. Among patients reporting at baseline and one year, average at-work performance improved from 80.7 to 89.4. A Wilcoxon signed-rank test indicated that post-operative performance was significantly higher than pre-operative performance (p Conclusion Among employed patients before TJA, presenteeism and absenteeism were similarly costly. After, employed patients reported increased performance, concentrated among those with declining performance leading up to surgery.