Return to Work Following Hip or Knee Arthroplasty: A One-Year Prospective Cohort Study in Participants with Direct Referral from Hospital to Occupational Health Care Services.

The study compared outcomes with earlier Finnish cohorts rather than with a concurrent control group, so it cannot show that any single part of the coordinated pathway caused faster return to work. Return to work was self-reported, and vacation days may have been included between surgery and return. Baseline expectations were answered while participants were recovering in hospital, so pain or the surgery itself may have influenced those answers. Of the 266 participants who answered baseline, 57 did not answer follow-up. Those dropouts had higher physical workload, more sick leave before surgery, and expected longer sick leave, so the analysed group may have returned faster than the original eligible group. The study was done in Finland, where occupational health care is statutory for employees, so the pathway may not transfer to systems without that structure. The exact number of eligible patients with occupational health care entitlement was unknown, and the target group was estimated.

Do not conclude that referral to occupational health care alone caused faster return to work. The coordinated pathway also included information before surgery, surgeon-prescribed short sick leave, referral to occupational health care, individual work assessment, occupational physiotherapy guidance, medical or vocational rehabilitation, including physiotherapy, arthritis rehabilitation courses, and work trials, joint negotiation with the employer, workplace adjustments, and follow-up by occupational health specialists. The paper compared results with earlier Finnish cohorts rather than with a concurrent group.