Abstract：
OBJECTIVE: In a new Finnish Coordinated Return to Work (CRTW) model, patients are referred to occupational health care after hip or knee arthroplasty. This study evaluated the CRTW model\'s effect on return to work (RTW), activities used in occupational health care and in the workplace, and the patient- and work-related factors affecting early RTW.
METHODS: 209 participants with occupational health care service underwent primary hip (THA) or total/unicondylar knee (KJA) arthroplasty and completed self-reported questionnaires after arthroplasty and at time of RTW. Factors affecting RTW, and the roles of occupational health care and the workplace in RTW were evaluated. Time to RTW was determined as days between the arthroplasty and RTW.
RESULTS: Mean time to RTW was 69 days after THA and 87 days after KJA. For easing RTW, work arrangements were made for 56% of the participants. The most utilized adjustments of work were enabling remote work and arranging limitations in work tasks. Participants with earlier RTW had lower physical workload, higher professional status and motivation to work, less pre-arthroplasty sick leave, and more positive personal expectations about the time to RTW compared to participants with later RTW (p < 0.001 for all). The linear regression and dominance analyses showed participants\' own expectations and pre-arthroplasty sick leave as the strongest factors affecting time to RTW.
CONCLUSIONS: The CRTW model seems to shorten time to RTW after THA and KJA. Occupational health care and workplace play important roles in supporting RTW. Patients\' own expectations should be noted when giving pre-arthroplasty information.
METHODS: 209 participants with occupational health care service underwent primary hip (THA) or total/unicondylar knee (KJA) arthroplasty and completed self-reported questionnaires after arthroplasty and at time of RTW. Factors affecting RTW, and the roles of occupational health care and the workplace in RTW were evaluated. Time to RTW was determined as days between the arthroplasty and RTW.
RESULTS: Mean time to RTW was 69 days after THA and 87 days after KJA. For easing RTW, work arrangements were made for 56% of the participants. The most utilized adjustments of work were enabling remote work and arranging limitations in work tasks. Participants with earlier RTW had lower physical workload, higher professional status and motivation to work, less pre-arthroplasty sick leave, and more positive personal expectations about the time to RTW compared to participants with later RTW (p < 0.001 for all). The linear regression and dominance analyses showed participants\' own expectations and pre-arthroplasty sick leave as the strongest factors affecting time to RTW.
CONCLUSIONS: The CRTW model seems to shorten time to RTW after THA and KJA. Occupational health care and workplace play important roles in supporting RTW. Patients\' own expectations should be noted when giving pre-arthroplasty information.
摘要：
目标：在新的芬兰协调返回工作（CRTW）模型中，髋关节或膝关节置换术后，患者应接受职业保健。本研究评估了CRTW模型对重返工作岗位(RTW)的影响，用于职业保健和工作场所的活动，以及影响早期RTW的患者和工作相关因素。
方法：209名接受职业保健服务的参与者接受了原发性髋关节（THA）或全/单髁膝关节（KJA）关节成形术，并在关节成形术后和RTW时完成了自我报告问卷。影响RTW的因素，并评估了职业保健和工作场所在RTW中的作用。RTW的时间确定为关节成形术和RTW之间的天数。
结果：RTW的平均时间为THA后69天和KJA后87天。为了缓解RTW，对56%的参与者进行了工作安排。最常用的工作调整是启用远程工作和安排工作任务的限制。早期RTW的参与者的身体工作量较低，更高的专业地位和工作动力，更少的关节成形术前病假，与RTW较晚的参与者相比，对RTW时间的个人期望更积极（全部p<0.001）。线性回归和优势分析显示，参与者自身的期望和关节成形术前的病假是影响RTW时间的最强因素。
结论：CRTW模型似乎缩短了THA和KJA后的RTW时间。职业保健和工作场所在支持RTW方面发挥着重要作用。在提供关节置换术前信息时，应注意患者自身的期望。
方法：209名接受职业保健服务的参与者接受了原发性髋关节（THA）或全/单髁膝关节（KJA）关节成形术，并在关节成形术后和RTW时完成了自我报告问卷。影响RTW的因素，并评估了职业保健和工作场所在RTW中的作用。RTW的时间确定为关节成形术和RTW之间的天数。
结果：RTW的平均时间为THA后69天和KJA后87天。为了缓解RTW，对56%的参与者进行了工作安排。最常用的工作调整是启用远程工作和安排工作任务的限制。早期RTW的参与者的身体工作量较低，更高的专业地位和工作动力，更少的关节成形术前病假，与RTW较晚的参与者相比，对RTW时间的个人期望更积极（全部p<0.001）。线性回归和优势分析显示，参与者自身的期望和关节成形术前的病假是影响RTW时间的最强因素。
结论：CRTW模型似乎缩短了THA和KJA后的RTW时间。职业保健和工作场所在支持RTW方面发挥着重要作用。在提供关节置换术前信息时，应注意患者自身的期望。
