Return to Work Following Shoulder Surgery: An Analysis of 1,773 Cases

肩关节手术后重返工作岗位:1773例病例分析

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Abstract

BACKGROUND: There is limited information on patients' ability to return to work (RTW) after the majority of shoulder surgical procedures. METHODS: This study was a retrospective analysis of prospectively collected data on 1,773 consecutive patients who underwent shoulder surgery performed by a single surgeon from 2004 to 2017. A validated L'Insalata Shoulder Questionnaire was used to collect information on 32 preoperative factors, which were used for analysis. The questionnaire included the premorbid level of work and the levels preoperatively and at 6 months postoperatively. RESULTS: 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 provided a significant improvement in work level (on a scale ranging from none to strenuous) 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. CONCLUSIONS: To our knowledge, this is the largest study of RTW outcomes of shoulder surgical procedures, and it showed that 4 out of 5 patients were able to RTW 6 months postoperatively with approximately half resuming full duties and half, lighter duties. Capsular release was the only procedure to result in a significant improvement in work level within 6 months. The best independent predictors of RTW were younger age, less stiffness, and working preoperatively. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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