Return to work following arthroscopic supraspinatus repair: a survey of UK practice

Abstract

Objective: The primary objective was to explore current practice and advice given to patients about a return to work (RTW) following arthroscopic supraspinatus repair (single tendon) by the patients surgeon and physiotherapist. The secondary objective was to explore the consensus on key predictive factors for successful phased and full return to work following arthroscopic supraspinatus repair surgery. Methods: An online electronic anonymous survey was developed and hosted by survey monkey to capture pertinent information relating to the return to work postoperatively. The survey was approved by British Elbow and Shoulder Society (BESS) research committee in 2017. The survey link was disseminated via email to expert shoulder surgeons and physiotherapist who are BESS members. Survey had a vignette with different age group, tear size, type of work and return to work advice. Consistency of responses and thereby the internal validity of the questionnaire was tested via a correlation analysis between responses. Results were comparatively analysed with Mann-Whitney U test and Chi-square tests. Results: Sixty-two valid responses were received (48 surgeons;14 physiotherapists). Regarding RTW time frames, a wide range of responses was received (sedentary work 0-12 weeks, light manual workers 2-24 weeks, and manual workers 3-36 weeks). Furthermore, responses varied among professionals (P=0.01). The range of motion of the operated shoulder, functional shoulder scores, self-reported patient scores and patient expectations were considered moderate to very important predictive factors for successful full RTW arthroscopic supraspinatus repair surgery. Pain, psychological profile, job satisfaction, and patient compliance were also considered relevant. 77% respondents said they liaise with occupational health departments and patient´s general practitioners with regards to their patient’s RTW. Conclusion: This is the first survey in the UK exploring current practices with regards to RTW after arthroscopic supraspinatus repair. Responses highlight variability in the advice given to the patients on phased and full return to work by the professionals even for a single tendon repair. There is a need to standardise the advice given to patients and further research is needed with patient public involvement to develop an evidenced-based guideline for RTW. Implications: Return to work is influenced by a combination of factors. The relationship between each of these needs to be explored in greater depth and wider understanding of the variables influencing the patient´s RTW following arthroscopic supraspinatus repair.