25premus084 10.3205/25premus084 urn:nbn:de:0183-25premus0848 Meeting Abstract Strijbos Strijbos Daniel D

Amsterdam UMC, locatie AMC, Amsterdam, Netherlands Nij Smellinghe hospital, Drachten, Netherlands

author Van der Sluis Van der Sluis Geert G

Nij Smellinghe Ziekenhuis, Drachten, Netherlands

author van Houtert van Houtert Wim W

Nij Smellinghe Ziekenhuis, Drachten, Netherlands

author Straat Straat A. Carlien AC

Amsterdam UMC, locatie AMC, Amsterdam, Netherlands

author van Zaanen van Zaanen Yvonne Y

Amsterdam UMC, locatie AMC, Amsterdam, Netherlands

author Kooijman Kooijman Carolien C

Nij Smellinghe Ziekenhuis, Drachten, Netherlands

author de Groot de Groot Stephan S

Elabo bv, Amersfoort, Netherlands

author Reneman Reneman Michiel M

UMCG Beatrixoord, Haren, Netherlands

author Boymans Boymans Tim T

Maastricht UMC+, Maastricht, Netherlands

author Kuijer Kuijer Paul P

Amsterdam UMC, locatie AMC, Amsterdam, Netherlands

author German Medical Science GMS Publishing House

Düsseldorf

610 20250909 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0625 084 12th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders PREMUS 2025 Oral PS 18 Tübingen 20250909 20250912 084 20251113The first name of author Straat has been added. TextBackground: Considering the increase in the demand from working age patients seeking knee arthroplasty (KA) and the low return-to-work (RTW) rates, optimization of care for patients getting KA with a focus on RTW is essential. We evaluated a work-integrated care pathway – Back At work After Surgery (BAAS) – aimed at improving RTW compared with usual care in the Netherlands.Method: In this multicenter controlled study of matching cohorts, working patients who had primary KA were included. Patients in two Dutch hospitals (BAAS cohort, n=145) received integrated medical and occupational care, including structured pre- and postoperative consultations, goal setting, activity tracking and interdisciplinary team meetings with both medical and occupational health professionals. Two separate control cohorts (Expect TO work: n=179; ACTIVE: n=133) from 15 hospitals/clinics received usual care. Primary outcomes were time to first day of RTW and time to full RTW within 12 months. IPTW was used with known prognostic factors as covariates to account for possible differences in baseline characteristics.Results: A total of 457 patients were included (BAAS n=145; Expect TO work n=179; ACTIVE n=133). The median time to first day of RTW was 16–25 days shorter in the BAAS cohort (27 days) compared to Expect TO work (52 days; hazard ratio [HR] 2.7; 95% confidence interval [CI]:2.1-3.4) and ACTIVE cohort (43 days; HR:1.95; CI:1.5-2.6). At three months, 90% of BAAS patients had started RTW versus 63% and 76% in the control cohorts. BAAS patients also achieved full RTW earlier, with a median time reduced by 27 days compared to the ACTIVE cohort (HR:1.4; CI:1.1-1.8; p=0.01). The odds of full RTW at 12 months were higher in the BAAS cohort compared to Expect TO work, namely odds ratio (OR) 3.9 (CI:1.2-12.9) and ACTIVE OR 9.3 (CI:2.9-29.7). Discussion: BAAS shifts the focus from symptom relief to meaningful recovery by enabling earlier and more successful work participation. The observed effects exceed MCID thresholds. Even without randomization, the real-world setting, strong methodology, and high implementation feasibility make BAAS a promising model for value-based perioperative care.Conclusions: The BAAS work-integrated care pathway was more effective than usual care in improving RTW after KA in the Netherlands. Strijbos DO van der Sluis G van Houtert WFC Straat AC van Zaanen Y de Groot S Klomp S Krijnen WP Kooijman CM van den Brand I Reneman MF Boymans TAEJ Kuijer PPFM Protocol for a multicenter study on effectiveness and economics of the Back At work After Surgery (BAAS): a clinical pathway for knee arthroplasty 2023 BMC Musculoskelet Disord 199 Strijbos DO, van der Sluis G, van Houtert WFC, Straat AC, van Zaanen Y, de Groot S, Klomp S, Krijnen WP, Kooijman CM, van den Brand I, Reneman MF, Boymans TAEJ, Kuijer PPFM. Protocol for a multicenter study on effectiveness and economics of the Back At work After Surgery (BAAS): a clinical pathway for knee arthroplasty. BMC Musculoskelet Disord. 2023 Mar 16;24(1):199. DOI: 10.1186/s12891-023-06203-5 http://dx.doi.org/10.1186/s12891-023-06203-5 0 0 0 0