Return to Work Outcomes After Common Sports-Related Orthopaedic Procedures: A Systematic Review Stratified by Occupational Intensity and Workers’ Compensation Status

BACKGROUND: Return to work (RTW), particularly return to full-duty occupational function, is a clinically meaningful outcome after sports-related orthopaedic surgery. However, reporting across procedures is heterogeneous and often lacks occupational context. PURPOSE: To synthesize full-duty RTW outcomes after common sports-related orthopaedic procedures in civilian populations. Secondary objectives were to describe the time to RTW and to evaluate outcomes stratified by occupational intensity and workers' compensation (WC) status. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Civilian studies reporting RTW outcomes after meniscectomy, meniscal repair, anterior cruciate ligament (ACL) reconstruction (ACLR), rotator cuff repair (RCR), distal biceps repair, biceps tenodesis, or hip arthroscopy were included. Data were extracted at the cohort level. Full-duty RTW rates were calculated using sample-size weighted pooled estimates. Time to RTW was summarized using the median of reported cohort-level mean RTW times. Occupational intensity-specific and WC-specific outcomes were analyzed descriptively when reported separately at the cohort level. RESULTS: A total of 87 unique studies met the inclusion criteria. Pooled full-duty RTW rates exceeded 90% after meniscectomy, meniscal repair, ACLR, and distal biceps repair. In contrast, pooled full-duty RTW rates after biceps tenodesis, RCR, and hip arthroscopy ranged from 74.2% to 76.7%. The median time to RTW ranged from 33 days after meniscectomy to 185 days after RCR. Across procedures with available data, WC cohorts and higher occupational intensity were associated with prolonged RTW timelines. CONCLUSION: Full-duty RTW outcomes vary by procedure type, with longer rehabilitation procedures demonstrating lower pooled RTW rates and longer median RTW timelines. WC status and higher occupational intensity were consistently associated with delayed RTW. Standardized reporting of occupational intensity, RTW definitions, and WC status is needed to improve clinical counseling and enhance comparability in future orthopaedic outcomes research.