Return-to-work following shoulder arthroplasty in adults with osteoarthritis

With an ageing Dutch population and a rising retirement age, a demand for work-related outcomes in medical research has emerged. Shoulder replacement surgery is no exception. Through a retrospective query, this study aims to examine return-to-work and its prognostic factors. A high return-to-work rate after shoulder replacement surgery has been found. Patients' expectation to fully return, absence of preoperative work adjustments and preoperative sick leave may be relevant factors contributing to return-to-work rates. Background Anatomic total shoulder arthroplasty (aTSA) and hemiarthroplasty (HA) have demonstrated significant improvement in shoulder function and pain relief. Work-related outcomes have become increasingly important, while the current literature lacks evidence related to return-to-work (RTW) and which factors might have an influence on it. Aims This study aimed to assess RTW in patients who have received aTSA or HA at a minimum of 1-year follow-up after surgery, and secondary to evaluate possible prognostic factors associated with RTW. Methods We performed a retrospective query in employed patients diagnosed with primary osteoarthritis of the shoulder, who received either an aTSA or HA between February 2006 and February 2021. Preoperative and post-operative work and sports participation were assessed. Results Forty-four patients participated in this study (98% compliance), of which 40 patients (91%) were able to RTW at a median time of two (interquartile range: 2-4) months post-operatively. Patients with a medium-/high-demand occupation demonstrated RTW at a significantly lower rate (79%) than those with light-demand occupations (100%; P = 0.03). There was a statistically significant association between return to full employment and patients' expectation to fully return, absence of preoperative work adjustments and preoperative sick leave (odds ratio: 16.9 [3.1-93.5]; 18.3 [2.1-160.4]; 0.1 [0.0-0.6]). Conclusions aTSA and HA facilitate excellent RTW rates. Patients with a medium-/high-demand occupation return at a significantly lower rate. The ability to RTW seems to be multifactorial and the results found might not be attributed to shoulder arthroplasty alone.