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, T M J Pahlplatz, M J M Hoozemans, L Blankevoort, M U Schafroth, D Haverkamp, T M J S Vervest, D H P W Das, V A Scholtes, A J van der Beek, P P F M Kuijer

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Purpose: The aim of this study is to investigate whether total knee arthroplasty (TKA) patients who consulted an occupational medicine specialist (OMS) within 3 months after surgery, return to work (RTW) earlier than patients who did not consult an OMS. Methods: A multi-center prospective cohort study was performed among working TKA patients, aged 18 to 65 years and intending to RTW. Time to RTW was analyzed using Kaplan Meier and Mann Whitney U (MWU), and multiple linear regression analysis was used to adjust for effect modification and confounding. Results: One hundred and eighty-two (182) patients were included with a median age of 59 years [IQR 54–62], including 95 women (52%). Patients who consulted an OMS were less often self-employed but did not differ on other patient and work-related characteristics. TKA patients who consulted an OMS returned to work later than those who did not (median 78 versus 62 days, MWU p < 0.01). The effect of consulting an OMS on time to RTW was modified by patients’ expectations in linear regression analysis (p = 0.05). A median decrease in time of 24 days was found in TKA patients with preoperative high expectations not consulting an OMS (p = 0.03), not in patients with low expectations. Conclusions: Consulting an OMS within 3 months after surgery did not result in a decrease in time to RTW in TKA patients. TKA patients with high expectations did RTW earlier without consulting an OMS. Intervention studies on how OMSs can positively influence a timely RTW, incorporating patients’ preoperative expectations, are needed.

Original languageEnglish
Pages (from-to)267-276
JournalJournal of Occupational Rehabilitation
Issue number2
Early online date9 Sept 2022
Publication statusPublished - 9 Sept 2022


  • Expectations
  • Occupational medicine specialist (OMS)
  • Return to work (RTW)
  • Total knee arthroplasty (TKA)

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