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Does Consulting an Occupational Medicine Specialist Decrease Time to Return to Work Among Total Knee Arthroplasty

Y van Zaanen1, A J Kievit2, R C I van Geenen3

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Consulting an occupational medicine specialist after total knee arthroplasty did not speed up return to work. Patients with high expectations returned to work sooner without specialist consultation.

Keywords:
ExpectationsOccupational medicine specialist (OMS)Return to work (RTW)Total knee arthroplasty (TKA)

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Area of Science:

  • Orthopedic Surgery
  • Occupational Medicine
  • Rehabilitation Science

Background:

  • Total knee arthroplasty (TKA) is a common procedure for knee osteoarthritis.
  • Return to work (RTW) is a significant outcome for TKA patients.
  • The role of occupational medicine specialists (OMS) in post-TKA RTW is not well-defined.

Purpose of the Study:

  • To investigate if consulting an occupational medicine specialist (OMS) within 3 months post-TKA influences the time to return to work (RTW).
  • To explore potential modifying factors, such as patient expectations, on the relationship between OMS consultation and RTW.

Main Methods:

  • A multi-center prospective cohort study involving 182 working TKA patients (aged 18-65).
  • Time to RTW was analyzed using Kaplan-Meier and Mann-Whitney U tests.
  • Multiple linear regression was used to adjust for confounding and effect modification.

Main Results:

  • Patients consulting an OMS returned to work later (median 78 days) than those who did not (median 62 days).
  • The effect of OMS consultation on RTW was modified by preoperative patient expectations.
  • TKA patients with high preoperative expectations who did not consult an OMS experienced a significantly earlier RTW (median decrease of 24 days).

Conclusions:

  • Consulting an OMS within 3 months post-TKA did not accelerate RTW.
  • High preoperative patient expectations were associated with earlier RTW, particularly in patients not consulting an OMS.
  • Further research is needed to develop interventions that leverage patient expectations to optimize RTW after TKA.