Return to Work Following Shoulder Surgery
These authors assessed the postoperative return to work (RTW) for a large series of patients having shoulder surgery by an individual surgeon.
Six months following the shoulder operations, 77% of the patients returned to work (40% with full duties and 37% with light duties).
Concomitant rotator cuff repair and stabilization was associated with the highest RTW rate (90%) whereas some of the lowest RTW rates were associated with reverse total shoulder arthroplasty (56%) and total shoulder arthroplasty (71%).
The highest rate of RTW with full duties was associated with debridement for calcific tendinitis (62%).
Capsular release was the only procedure to result in a significant improvement in work level within 6 months, providing a significant improvement in work level from preoperatively to postoperatively (p = 0.0116).
Older patients with stiffer shoulders who were not working preoperatively had the lowest RTW rate at 6 months.
The most significant factors were assessed using a multiple logistic regression analysis in order to identify independent factors that best predict whether patients will RTW at 6 months postoperatively. The best independent predictors of RTW were younger age, less stiffness, and working preoperatively.
Comment: This study of the practice of an individual surgeon demonstrates that return to work is likely to be a different metric than patient reported outcome measures (PROMs). It would have been interesting to see the relation between the two, in other words, how did improvement in PROM relate to RTW?
It is surely humbling to see that only one of the procedures studied was successful in improving the mean work level at 6 months after surgery. If improving the ability to perform work is the primary objective of the surgery, a candid discussion of likelihood and predictors of success would seem warranted.
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