常见运动相关骨科手术后的重返工作结局：一项按职业强度与工伤赔偿状态分层的系统综述
简介
该研究系统综述了87项研究，评估了常见运动医学手术（包括ACL重建、半月板切除/修复、肩袖修复等）后重返全职工作的比例与时间。结果显示，半月板手术和ACL重建后重返工作率超过90%，而肩袖修复和髋关节镜术后仅约75%；工人赔偿状态和较高职业强度与延迟重返工作显著相关。临床咨询时需结合患者职业强度与赔偿状态，以更精准地预测术后复工时间。
英文摘要
BACKGROUND: Return to work (RTW), particularly return to full-duty occupational function, is a clinically meaningful outcome after sports-related orthopaedic surgery. However, reporting across procedures is heterogeneous and often lacks occupational context. PURPOSE: To synthesize full-duty RTW outcomes after common sports-related orthopaedic procedures in civilian populations. Secondary objectives were to describe the time to RTW and to evaluate outcomes stratified by occupational intensity and workers' compensation (WC) status. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Civilian studies reporting RTW outcomes after meniscectomy, meniscal repair, anterior cruciate ligament (ACL) reconstruction (ACLR), rotator cuff repair (RCR), distal biceps repair, biceps tenodesis, or hip arthroscopy were included. Data were extracted at the cohort level. Full-duty RTW rates were calculated using sample-size weighted pooled estimates. Time to RTW was summarized using the median of reported cohort-level mean RTW times. Occupational intensity-specific and WC-specific outcomes were analyzed descriptively when reported separately at the cohort level. RESULTS: A total of 87 unique studies met the inclusion criteria. Pooled full-duty RTW rates exceeded 90% after meniscectomy, meniscal repair, ACLR, and distal biceps repair. In contrast, pooled full-duty RTW rates after biceps tenodesis, RCR, and hip arthroscopy ranged from 74.2% to 76.7%. The median time to RTW ranged from 33 days after meniscectomy to 185 days after RCR. Across procedures with available data, WC cohorts and higher occupational intensity were associated with prolonged RTW timelines. CONCLUSION: Full-duty RTW outcomes vary by procedure type, with longer rehabilitation procedures demonstrating lower pooled RTW rates and longer median RTW timelines. WC status and higher occupational intensity were consistently associated with delayed RTW. Standardized reporting of occupational intensity, RTW definitions, and WC status is needed to improve clinical counseling and enhance comparability in future orthopaedic outcomes research.