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Arch Orthop Trauma Surg. 2017 Feb;137(2):155-166. doi: 10.1007/s00402-016-2594-6. Epub 2016 Nov 21.

Beneficial and limiting factors for return to work following anterior cruciate ligament reconstruction: a retrospective cohort study.

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CORAL-Center for Orthopaedic Research Alkmaar, Orthopaedic Department, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.
Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
CORAL-Center for Orthopaedic Research Alkmaar, Orthopaedic Department, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.
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.



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.


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.


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.


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.


ACL reconstruction; Anterior cruciate ligament; Return to work; Work load

[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

The authors declare that they have no conflict of interest. Funding There is no funding source. Ethical approval This study was performed in accordance with the guidelines on Good Clinical Practice of the International Conference on Harmonisation [23] and the Declaration of Helsinki [24]. However, medical ethical approval of the study was not required. Informed consent Informed consent was obtained from all individual participants included in the study.

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