Our results demonstrate that compensated patients had a longer time of absence from work following orthopedic surgery. Although this finding may be intuitive, this study demonstrates this relationship using a rigorous, systematic perspective.
Some studies have previously demonstrated that time to return to work is not an optimal measure for surgeons when assessing post-surgery outcomes[4, 16, 17]. However, return to work time is an important consideration as it contributes to social and economical burden.
Factors that influence earlier or later return to work are well-established in the literature and typically relate to the particular health condition, surgical intervention, the surgeon’s approach for post-operative treatment and care and patient characteristics[1, 4]. This study demonstrates that the presence of Worker’s Compensation is an additional factor that predicts a longer return to work period post-surgery.
This meta-analysis provides quantitative data as Standardized Mean Difference. This is not a directly usable measure, as it measures the standardized difference between the standard deviations between the groups of interest. This measure is frequently used in Cochrane Reviews when different scales are pooled in the same forest plot. In our study, this quantification allows us to state that compensated patients take longer to return to work compared to non-compensated patients and the magnitude of this effect is strong.
The small number of included studies and the lack of studies including different conditions reduced the external validity of our results as our findings may not be generalizable to other patient populations. We opted not to include lower limb diseases or acute injuries (e.g. fractures) since this would increase the heterogeneity of our results in an inacceptable manner for our outcome of interest. This study is strengthened by the robustness of the methodology, the strict inclusion criteria and quality assessment.