Does Consulting an Occupational Medicine Specialist Decrease Time to Return to Work Among Total Knee Arthroplasty Patients? A 12-Month Prospective Multicenter Cohort Study.
Y van Zaanen, A J Kievit, R C I van Geenen and 10 others
PMID 36083360WHAT IT FOUND
Consulting an occupational medicine specialist within three months of total knee replacement did not speed up return to work.
Patients who saw a specialist returned to work later than those who did not, especially those with high preoperative expectations of their work ability.
Key findings
01Patients who consulted an occupational medicine specialist within three months after surgery returned to work later (median 78 days) than patients who did not consult one (median 62 days).
02Among patients with high preoperative expectations of work ability, those who consulted a specialist returned to work 24 days later than those who did not.
03Working hours, work ability, and satisfaction with work ability at six and twelve months did not differ between patients with high expectations who did and did not consult a specialist.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was observational, not randomized, so selection bias is possible; patients who consulted an OMS may have had unmeasured factors (like lower self-efficacy or more complex psychosocial issues) that delayed their return to work independently of the consultation. Data on OMS consultation and return to work were self-reported, and the study did not capture the content or exact timing of the OMS advice, only whether a consultation occurred within 3 months. The study excluded the first 49 patients for the 3-month measurement due to ethical approval delays, though the authors expect this to be random. Psychosocial factors such as supervisor support and self-efficacy were not measured, which are known to influence return to work.
Declared interests
The text does not explicitly state funding sources or conflicts of interest in the provided sentences, but notes that hospitals varied from general to tertiary university hospitals.
The easy way to misread this
Do not interpret the later return to work in the OMS group as proof that specialist consultation causes delay. Because this was a cohort study and not a randomized trial, patients who sought OMS advice may have been those with more barriers to work or lower confidence, meaning the association could reflect patient characteristics rather than the effect of the consultation itself.