Why OPAL?

What is the problem?

Current national guidelines recommend that orthopaedic teams discuss and provide information about returning to work to patients undergoing hip and knee replacement operations.

Despite these recommendations, many patients to not receive any advice and support. If advice and support is provided it is often overly cautious and prevents people getting back to work even though they can. Less than a third of patients have access to occupational health support at work.

There is a need for an occupational support programme that encourages safe and sustained return to work.

Why this research is important?

Planned surgery to replace a hip or knee joint is a routine NHS procedure that is becoming more common in people of working age.

A quarter of UK patients undergoing primary hip and knee replacement are in work at the time of surgery (approximately 50,000 a year). This number will rise in the coming years as there will be a greater number of with hip and knee arthritis and people will be working longer.

Returning to work is important as it has physical and mental health benefits and aids recovery after joint replacement.

Why is this research needed now?

The advice provided by health care professionals about returning to work after surgery plays an important role in determining when patients return to work. It is important to provide appropriate advice and support and help patients set realistic and achievable expectations about their return to work after surgery. Encouraging and supporting return to work through an occupational programme initiated prior to surgery could help to minimise some of the health and socioeconomic consequences of joint replacement surgery.

Determinants of return to work are rarely considered when advising patients about hip and knee replacement surgery and their return to work after surgery.

In a UK survey only 1 in 5 healthcare respondents routinely offered return to work advice to their patients and only 1 in 10 provided written information or offered onward referral to occupational health services. There is room for improvement to ensure all patients are offered advice and support and bring current practice in line with current national guidelines.