title: Beneficial and limiting factors for return to work following anterior cruciate ligament reconstruction: a retrospective cohort study.
abstract: OBJECTIVE
  Evidence-based advice for return to work (RTW) after anterior cruciate ligament (ACL) reconstruction is not available. Therefore, the objectives of this study were to determine when patients achieve full RTW, and to explore the beneficial and limiting factors for fully RTW after ACL reconstruction.
  
  
  METHODS
  A retrospective cohort study was performed after ACL reconstruction among 185 patients in one hospital. Data from patient files and a questionnaire were used to explore whether patient-, injury-, surgery-, sports-, work- and rehabilitation-related factors are beneficial or limiting for fully RTW after ACL reconstruction, using a backward stepwise logistic regression analysis.
  
  
  RESULTS
  Of the 125 (68%) patients that returned the questionnaire, 36 were not part of the working population. Of the remaining 89 patients, 82 patients (92%) had returned fully to work at follow-up. The median time to fully RTW was 78 days. In the final regression model, which explained 29% of the variance, a significant OR of 5.4 (90% CI 2.2-13.1) for RTW > 78 days was observed for patients performing heavy knee-demanding work compared to patients performing light knee-demanding work. In addition, a significant and positive OR (1.6, 90% CI 1.2-1.9) for the number of weeks walking with the aid of crutches for RTW > 78 days was observed in the final model.
  
  
  CONCLUSIONS
  After ACL reconstruction, 92% of the patients fully return to work at a median time of 78 days. The significant predictors for fully RTW > 78 days are performing heavy knee-demanding work and a longer period of walking aided with crutches after ACL reconstruction.
authors.affiliation: CORAL-Center for Orthopaedic Research Alkmaar, Orthopaedic Department, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.
authors.forename: Judith A M
authors.initials: JA
authors.lastname: Groot
authors.affiliation: CORAL-Center for Orthopaedic Research Alkmaar, Orthopaedic Department, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.
authors.forename: Freerk J
authors.initials: FJ
authors.lastname: Jonkers
authors.affiliation: Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Kievit
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: P Paul F M
authors.initials: PP
authors.lastname: Kuijer
authors.affiliation: CORAL-Center for Orthopaedic Research Alkmaar, Orthopaedic Department, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands. m.j.m.hoozemans@vu.nl.|Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, Van der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands. m.j.m.hoozemans@vu.nl.
authors.forename: Marco J M
authors.initials: MJ
authors.lastname: Hoozemans
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D062707:Return to Work; D011795:Surveys and Questionnaires
keywords: ACL reconstruction; Anterior cruciate ligament; Return to work; Work load