The return to work after arthroplasty (REWARD) cohort: a nationwide longitudinal study of sick leave and disability pension among individuals receiving hip and knee arthroplasty in Sweden.

Authors

Kristin Gustafsson, Per Liv, Ola Rolfson, P Paul F M Kuijer, Sebastian Mukka, Jens Wahlström

Published in

BMJ open. Volume 16. Issue 7. Pages e119123. Jul 15, 2026. Epub Jul 15, 2026.

Abstract

The return to work after arthroplasty (REWARD) study was established to address knowledge gaps regarding factors influencing return to work and long-term workability following hip and knee arthroplasty. The study investigates how variables such as sex, occupational workload and prior treatments affect sick leave patterns across regions and healthcare providers in Sweden. By analysing trajectories of sick leave and disability pension before and after surgery, the study aims to identify determinants for successful return to work.
Initially, we identified two separate cohorts comprising all individuals registered in the Swedish Arthroplasty Register who received a primary hip or knee arthroplasty between 2012 and 2022. Eligible individuals were 18-69 years of age and had osteoarthritis (OA) as the indication for surgery. For each of the arthroplasty cohorts, Statistics Sweden created a reference cohort by randomly selecting three individuals from the general population for each arthroplasty case, matched on age, sex and municipality.
Using linked nationwide registers, we identified 64 370 individuals who received primary hip arthroplasty and 60 683 who received knee arthroplasty during 2012-2022, all aged 18-69 years and diagnosed with OA. Median age was 62 years (IQR 56-66) for hip and 63 years (IQR 58-66) for knee arthroplasty; 52% and 55% were women respectively.The corresponding matched cohorts consisted of 193 110 and 182 049 individuals respectively.The dataset includes patient and surgical characteristics, 1-year patient-reported outcomes, first-line treatment participation, socioeconomic data, occupational exposures and sick leave and disability pension data (5 years before and after surgery). Data collection is complete.
The REWARD cohort is intended for longitudinal analysis of return to work and long-term workability following hip and knee arthroplasty, and for quantifying associated societal costs. Data collection is anticipated to be completed in 2027, pending potential linkage of comorbidity and prescribed medication data. Findings from REWARD will inform national guidelines and decision support tools for sick leave and work-related rehabilitation. Future work includes co-developing individualised, work-oriented interventions in collaboration with patients and healthcare professionals.

PMID:
42457430
Bibliographic data and abstract were imported from PubMed on 16 Jul 2026.

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