Systematic Review and Meta-Analysis of Outcomes in Workers’ Compensation Patients Following Knee Surgery
Date
Authors
Xia, Weisi
Mullen, Michaela
Johnstone, Ryan
Devane, Peter
Reid, Duncan
Supervisor
Item type
Journal Article
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Journal Title
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Volume Title
Publisher
Elsevier BV
Abstract
Background: An increasing volume of orthopaedic procedures are being performed worldwide, particularly in the working age population. Workers’ compensation (WC) is an insurance framework designed to support workers who are injured or become injured and has been associated with poor outcomes following a number of orthopaedic procedures. This systematic review aims to investigate post-operative outcomes in WC compared with non-workers’ compensation (NWC) patients following knee arthroplasty and arthroscopy. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE and Google Scholar databases were assessed from inception to 9th August 2025. Meta-analysis of WC undergoing knee arthroplasty was performed using Review Manager v5.4.1 using a random effects model. Results: An initial 513 records were initially identified. Eight retrospective observation studies were included, consisting of five studies investigating arthroplasty and three studies investigating knee arthroscopy. Meta-analysis of the arthroplasty studies showed a significantly reduced Knee Society knee (MD = -16.14, P=0.002) and function (MD = -12.08, P<0.00001) scores, reduced range of motion (MD = -5.99, P=0.0002) and increased complications (OR = 5.83, P=0.03) in the WC group. There were reduced return to work rates or prolonged time off work. Moderate to high individual risk of bias were evident in the reviewed studies. Conclusion: WC status is associated with poorer Knee Society scores, reduced range of motion and increased complications following knee arthroplasty. However, the strength of evidence is low to moderate with serious biases with caution advised on its interpretation.Description
Keywords
Workers’ Compensation, Knee Surgery, Total Knee Arthroplasty, Systematic Review
Source
Journal of Orthopaedic Reports, ISSN: 2773-157X (Print), Elsevier BV, 101028-101028. doi: 10.1016/j.jorep.2026.101028
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© 2026 The Authors. Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation. Note: This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.