Impact of major postoperative complications on employment and earnings after elective hip or knee replacement surgery: a population-based matched cohort study.

Calvin Diep, Rachael Jaffe, Christopher Witiw, Julian F Daza, Duminda N Wijeysundera, Bheeshma Ravi, Karim S Ladha

Abstract read

In one paragraph

Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it

0cells of the map it votes in

1citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

Rapid molecular culture versus conventional culture for periprosthetic joint infection: diagnostic performance and clinical relevance.Journal of bone and joint infection · 2026
Article

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Calvin DiepDepartment of Anesthesiology & Pain Medicine, University of Toronto, 123 Edward St (12th Floor), Toronto, ON, M5G 0A8, Canada. calvin.diep@mail.utoronto.ca.ORCID 0000-0001-9596-5101

Rachael JaffeInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Christopher WitiwInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Julian F DazaInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Duminda N WijeysunderaDepartment of Anesthesiology & Pain Medicine, University of Toronto, Toronto, ON, Canada.

Bheeshma RaviDivision of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.

Karim S LadhaDepartment of Anesthesiology & Pain Medicine, University of Toronto, Toronto, ON, Canada.

Funding

Canadian Anesthesiologists' Society CAS-2023-023Research Support, Non-US Gov’t

6 · The paper itself

Abstract

purposePostoperative complications can steer patients away from a typical surgical recovery trajectory and hinder their ability to work and earn income. We aimed to quantify these effects for working-aged adults after elective joint replacement surgery.

methodsWe conducted a population-based cohort study of adults aged 30-63 yr having elective hip or knee arthroplasty using the Canadian Hospitalization and Taxation Database from 2004 to 2019. Our primary exposure was a postoperative complication, defined as a composite of adverse medical events, intensive care unit visit, or rehospitalization within thirty days. Our coprimary outcomes were employment and earnings in the second calendar year after surgery. We matched patients with complications 1:1 to those without complications using a propensity score considering demographic, medical, and financial characteristics. We used probit regression to assess employment after surgery and difference-in-difference ordinary least squares regression for the change in earnings from before to after surgery.

resultsWe included 222,087 adults undergoing an elective hip or knee replacement. In total, 6.3% experienced postoperative complications. In the second year after surgery, 55.1% of patients with complications were working compared with 57.3% of patients without complications (-2.2 percentage points [pp], 95% confidence interval [CI], -3.5 to -1.0). Patients with complications had a CAD 1,782 greater decline in annual earnings from before surgery (95% CI, -2,775 to -789; values inflated to 2023 Canadian dollars) than patients without complications.

conclusionsPostoperative complications resulted in a lower likelihood of employment and lower earnings after elective hip or knee replacement surgery. This may also have broader economic implications.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeEmploymentIncomePostoperative ComplicationsAdultCanadaCohort StudiesElective Surgical ProceduresFemaleHumansMaleMiddle Agedemploymentincomejoint replacementpatient-centred outcomespostoperative complications

Identifiers

PMID40355799

DOI10.1016/j.bja.2019.11.025

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.