Predictive factors for the duration until return to work after surgery for work‐related rotator cuff syndrome: A prospective study of 92 workers

Abstract

Background Return to work (RTW) after surgery for a work‐related rotator cuff disorder (WRRCD) is often difficult. The study's purpose was to identify preoperative factors predicting RTW. Methods Ninety‐two workers with a WRRCD were identified by four surgeons. Before surgery, the workers completed a series of standardized questionnaires related to working conditions, health, and health beliefs. They were followed up prospectively for 20 months. Statistical analysis was based on single and multiple‐factor Cox models of the duration of absence from the time of surgery until RTW. Results The median age at inclusion was 49 years (27–62), with 52 women included (57%). Sixty‐one subjects (66%) were employed in highly physically demanding jobs. Forty‐two (46%) stayed at work until their surgery, whereas preoperative sick leave exceeded 100 days in 20 subjects (21%). Twenty months after surgery, 14 were still not back at work. For the other participants, the mean duration until RTW was 225 days (SD 156). In the fully adjusted model, variables that were significantly predictive of the duration until RTW were: work physical demand levels, preoperative sick leave, the number of body parts causing pain or discomfort in the last 12 months, self‐assessed 2‐year workability, and the Readiness for RTW (RRTW) Scale. Conclusions Several physical, psychological, and work‐related factors, easily recorded, can be identified preoperatively. They may be predictive of delayed return, loss of employment, or employability as a result of shoulder surgery.

Rates of Return to Manual Labor After Arthroscopic Rotator Cuff Repair

“…In addition to physically strenuous work, older age and workers’ compensation status increase the likelihood of unsatisfactory outcomes after aRCR. 4,6,27,30 Attempts to summarize these findings prove difficult, as it is difficult to accurately capture what truly drives poor outcomes. Is it the poor tissue quality secondary to advanced patient age, high rotator cuff demand upon return to work, secondary gain because of a workers’ compensation claim, or some combination thereof?…”

“…As a single unifying definition for manual labor has not been established, manual labor was defined as any job that requires physical strength, such as heavy lifting or prolonged heavy use of the operative shoulder. 6,14,23,28,30,32 All the professions included in this study, according to the Bureau of Labor Statistics, required heavy lifting and high levels of upper body strength. 28 Degree of shoulder use was further stratified according to the Canadian Classification and Dictionary of Occupations to fully capture patient-specific shoulder use within his or her profession.…”

Effect of Retear After Arthroscopic Rotator Cuff Repair on Return to Work and Sports in Nonathletes: A Retrospective Cohort Study

“…However, in the multivariable analysis, active workload was significantly associated with unsuccessful return to work (P ¼ .034), whereas preoperative participation in shoulder-related sports was associated with successful return to work (P ¼ .016). Previous studies have identified heavy physical labor, 9,16,18,20,22,38 involvement of the dominant arm, 16,18 older age, 11,22 female sex, 9 less participation in sports, 22 and low postoperative PROMs 16,36 to be associated with poor return to previous work after rotator cuff repair. The findings of this study are consistent with those of these previous studies and additionally identified preoperative participation in shoulder sports as an independent factor that aids successful return to previous work.…”

Predictors of Return to Work Following Primary Arthroscopic Rotator Cuff Repair: An Analysis of 1502 Cases

“…Specifically, several studies have found that patients who had more physically intensive jobs before sustaining rotator cuff tears were less likely to return to work after an arthroscopic rotator cuff repair. 1,5,12,13,15,23 Aagaard et al 1 and Gutman et al 12 found that patients who sustained rotator cuff tears on the side of their dominant arm were less likely to return to work than were patients who sustained tears on their nondominant side. Collin et al 5 and Imai et al 15 found that female patients were less likely to return to work after a rotator cuff repair y than were male patients.…”

“…Specifically, several studies have found that patients who had more physically intensive jobs before sustaining rotator cuff tears were less likely to return to work after an arthroscopic rotator cuff repair. 1 , 5 , 12 , 13 , 15 , 23 …”