Return to farming after orthopedic surgery: A systematic review

Area of Science:

• Orthopedic Surgery
• Occupational Health
• Rural Health Disparities

Background:

• Growing focus on healthcare disparities, particularly in rural areas.
• Limited research on return to work (RTW) for farmers and heavy laborers post-orthopedic surgery.
• Urban-centric studies often overlook the needs of rural patient populations.

Purpose of the Study:

• To systematically evaluate existing literature on RTW rates in farming and heavy labor occupations following hip, knee, or shoulder orthopedic surgery.
• To identify factors influencing RTW in these specific patient groups.
• To highlight gaps in current research for rural patient populations.

Main Methods:

• Systematic literature search of PubMed and EMBASE databases adhering to PRISMA guidelines.
• Inclusion criteria: patients in farming/heavy labor, RTW data post-hip, knee, or shoulder surgery, minimum 6-month follow-up.
• Meta-analysis of proportions performed on three observational studies for arthroscopic shoulder surgery RTW rates.

Main Results:

• Ten studies included 101 farmers out of 440 patients; focus on shoulder surgery (7 studies).
• RTW rates varied widely (24%-100%) by surgery type and follow-up; hip arthroplasty showed 53.6% RTW at 1 year.
• Pooled RTW rate for arthroscopic shoulder surgery was 89%; anatomic total shoulder arthroplasty showed higher odds of RTW (OR=5.45) compared to reverse shoulder arthroplasty.

Conclusions:

• High RTW rates observed for farmers and heavy laborers post-shoulder surgery.
• Significant need for rural-specific research to inform patient counseling and rehabilitation for hip and knee orthopedic surgery.
• Underscores disparities in research focus for underserved rural populations undergoing orthopedic procedures.