Background and objective:
Worldwide, enhance numbers of patients receive total hip arthroplasty (THA), primarily due to arthrosis. In addition, the number of patients of working age is rising, partially due to decreasing age at surgery. As a result, a wider and diverse range of outcome goals including daily participation an return to work (RTW) are gaining interest. As for the Netherlands, implementing the gatekeeper improvement act requires a minimum of two years of sick-leave payment by the employer, which makes early RTW of primary importance for society. Thus far, studies on RTW have only focused on the first year after surgery. In this study, the aim is to gain insight into factors influencing RTW two years after receiving THA.

Methods:
In this single-center retrospective cohort study, performed at Zuyderland Medical center, Sittard-Geleen, all primary THA patients aged under 65 (n=398), operated between January 2016 and February 2018, received a questionnaire including qualitative and quantitative questions addressing RTW and factors influencing this process. Descriptive statistics were used to analyze.

Results:
In total, 182 patients responded (response rate 45.7%), of which 145 patients (mean age 58.6 ± 5.6 years; female: n=74) completed the questionnaire. Prior to surgery, 112 patients were employed; 9 patients were self-employed. Within 12 weeks after surgery, 52% returned to work, 14% within 104 weeks. (pre)Retirement took place in 32 patients. In 19 cases, adjustments were made to working- hours or activities. For patients, who had an occupational physician involved, RTW was 85%. Contributing factors to early RTW were personal and social support, whereas physically demanding work conditions delayed or inhibited RTW

Conclusion:
Overall, the majority of patients returned to work within 12 weeks after surgery. After two years, all of them were still at work. They were satisfied with the guidance of their specialist and occupational physician.