Return to Work Following Osteochondral Allograft Transplantation in the Knee

This study evaluates return-to-work (RTW) timing and level in a large cohort of knee osteochondral allograft transplant (OCAT) patients in order to characterize RTW variables associated with successful outcomes and clarify expectations stratified by occupational category.

A prospective joint preservation registry was used to analyze RTW following primary knee OCAT. Patient demographic, surgical, and RTW timing variables were extracted from the medical record. The United States Bureau of Labor Statistics Standard Occupational Classification system was used to classify patients into 23 major occupational groups and to classify physical level of work (low, moderate, high).

161 employed patients and 35 students were analyzed; 156 patients (96.9%) returned to work, and all students (100%) returned to school. No demographic or surgical factors analyzed were significantly associated with RTW failure. A mean return to light duty occurred at 57 days (range: 2-373 days), and mean return to full duty at 211 days (range: 17-1,073 days) after OCAT. Patients in high demand jobs were significantly (p = .002) more likely to report a delayed return (> 55 days to return) to light duty. High demand jobs (p < .01) and male sex (p = .003) were significantly associated with a delayed return (> 216 days) to full duty.

RTW was achieved by 97% of patients after OCAT, with timing of RTW strongly influenced by occupational physical demands. This study provides clinicians and patients with practical guidance to support shared decision-making and pre-operative planning.