Return to Work after Total Ankle Arthroplasty

Category: Ankle Arthritis; Ankle Introduction/Purpose: End-stage ankle arthritis has demonstrated as detrimental an impact on work status and quality of life as that of the knee or hip. Inability to return to work, whether sedentary or physical, can incur significant economical burden. Total ankle arthroplasty has emerged as an increasingly common surgical treatment for end-stage ankle arthritis but its ability to enable patients’ return to work has not been elucidated. Methods: Patients from January 1st, 2020 to January 1st, 2024 were included in a multicenter prospective database for end-stage ankle arthritis treated with a total ankle replacement. Inclusion criteria included patients younger than 65 years, actively employed at the time of surgery, and two years of follow up. This cohort had 57 patients with an average age of 50.6 ± 12.6 years and was balanced in terms of sex (49% female). Foot function index (FFI), ankle osteoarthritis (AOS), and SF-36 scores were obtained pre and post-operatively. Results: All patient outcome scores significantly improved after arthroplasty (p < 0.01). The employment rate prior to surgery was 86% (49), which decreased to 78.9% (45) at the 2-year postoperative mark and was significant (p=0.024). Patients returned to sedentary and manual labor work at an average 2.8 and 13.3 weeks after surgery, respectively. Conclusion: After total ankle arthroplasty, patients younger than 55 returned to sedentary work at a mean 2.8 weeks post-operatively. And 13.3 weeks when returning to weight bearing labor. At 2-year follow-up, significantly more were unemployed (86% to 78.9%, p=0.024). This small cohort provides a launch point for patient discussion regarding their timeline to return to manual labor after total ankle arthroplasty.