Title: Activity impairment and work productivity loss after total knee arthroplasty: a prospective study

Abstract Background Total Knee Arthroplasty (TKA) is increasingly performed among working-aged individuals, highlighting the importance of work-related outcomes. Therefore, the aim was to examine the extent of both activity impairment outside work and work productivity (absenteeism, presenteeism, at-work productivity loss) at 6- and 24-months post-TKA surgery. Additionally, associated risk factors with these outcomes were evaluated. Methods This analysis included 183 patients Results At 6 months, the mean activity impairment was 22.8% (standard deviation (SD) 23.5) dropping to 17.1% (23.1) by 24-months. Among workers, presenteeism was 18.4% (24.6) and at-work productivity loss was 20.8% (26.1). Both dropped significantly by 24-months to 14.2% (22.4) and 12.9% (20.9), respectively. Absenteeism levels were low at both time points. Pain catastrophizing was associated with all outcomes. Conclusion This study showed that activity impairment and work productivity-loss are common following TKA, decreased significantly over time, but still existed two years postoperatively. Those reporting high levels of pain catastrophizing may benefit from targeted rehabilitation guidance to reduce and possibly prevent activity impairment and work productivity-loss.