{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T18:03:36Z","timestamp":1784138616920,"version":"3.55.0"},"reference-count":22,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"unspecified","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ALF agreement","award":["ALFGBG-1006713"],"award-info":[{"award-number":["ALFGBG-1006713"]}]},{"name":"Futurum-Academy for Health and Care, Region J\u00f6nk\u00f6ping County, Sweden","award":["1003006"],"award-info":[{"award-number":["1003006"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,2]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>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\u201369 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings to date<\/jats:title>\n                    <jats:p>Using linked nationwide registers, we identified 64 370 individuals who received primary hip arthroplasty and 60 683 who received knee arthroplasty during 2012\u20132022, all aged 18\u201369 years and diagnosed with OA. Median age was 62 years (IQR 56\u201366)\u2009for hip and 63 years (IQR 58\u201366) for knee arthroplasty; 52% and 55%\u2009were women respectively.<\/jats:p>\n                    <jats:p>The corresponding matched cohorts consisted of 193 110 and 182 049 individuals respectively.<\/jats:p>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Future plans<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-119123","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T17:05:53Z","timestamp":1784135153000},"page":"e119123","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3403-229X","authenticated-orcid":false,"given":"Kristin","family":"Gustafsson","sequence":"first","affiliation":[{"name":"Department of Health, Medicine and Caring Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Rehabilitation Centre, Ryhov County Hospital, J\u00f6nk\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5494-8134","authenticated-orcid":false,"given":"Per","family":"Liv","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Ume\u00e5 University, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Rolfson","sequence":"additional","affiliation":[{"name":"Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8277-3730","authenticated-orcid":false,"given":"P Paul F M","family":"Kuijer","sequence":"additional","affiliation":[{"name":"Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5469-2730","authenticated-orcid":false,"given":"Sebastian","family":"Mukka","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Intervention, Ume\u00e5 University, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2359-509X","authenticated-orcid":false,"given":"Jens","family":"Wahlstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Global Health, Ume\u00e5 university, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"2026071510052369000_16.7.e119123.1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00163-7"},{"key":"2026071510052369000_16.7.e119123.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30417-9"},{"key":"2026071510052369000_16.7.e119123.3","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1002\/acr.25101","article-title":"Core Recommendations for Osteoarthritis Care: A Systematic Review of Clinical Practice Guidelines","volume":"75","author":"Conley","year":"2023","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026071510052369000_16.7.e119123.4","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2014.913224"},{"key":"2026071510052369000_16.7.e119123.5","doi-asserted-by":"crossref","first-page":"426","DOI":"10.3109\/17453674.2015.1034608","article-title":"Historical view and future demand for knee arthroplasty in Sweden","volume":"86","author":"Nemes","year":"2015","journal-title":"Acta Orthop"},{"key":"2026071510052369000_16.7.e119123.6","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.artd.2022.05.012","article-title":"A Scoping Review of Total Hip Arthroplasty Survival and Reoperation Rates in Patients of 55 Years or Younger: Health Services Implications for Revision Surgeries","volume":"16","author":"Negm","year":"2022","journal-title":"Arthroplast Today"},{"key":"2026071510052369000_16.7.e119123.7","doi-asserted-by":"crossref","first-page":"2598","DOI":"10.1016\/j.arth.2017.02.069","article-title":"Total Knee Arthroplasty for Osteoarthritis in Patients Less Than Fifty-Five Years of Age: A Systematic Review","volume":"32","author":"Aujla","year":"2017","journal-title":"J Arthroplasty"},{"key":"2026071510052369000_16.7.e119123.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31665-9"},{"key":"2026071510052369000_16.7.e119123.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32531-5"},{"key":"2026071510052369000_16.7.e119123.10","doi-asserted-by":"publisher","DOI":"10.1002\/msc.1701"},{"key":"2026071510052369000_16.7.e119123.11","doi-asserted-by":"crossref","first-page":"457","DOI":"10.5271\/sjweh.3915","article-title":"Prevention at work needed to curb the worldwide strong increase in knee replacement surgery for working-age osteoarthritis patients","volume":"46","author":"Kuijer","year":"2020","journal-title":"Scand J Work Environ Health"},{"key":"2026071510052369000_16.7.e119123.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-023-16723-3","article-title":"Work-related outcomes in individuals with and without lower limb osteoarthritis: an online survey","volume":"23","author":"Alyousef","year":"2023","journal-title":"BMC Public Health"},{"key":"2026071510052369000_16.7.e119123.13","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1080\/17453674.2016.1269051","article-title":"Sick leave in Sweden before and after total joint replacement in hip and knee osteoarthritis patients","volume":"88","author":"Stigmar","year":"2017","journal-title":"Acta Orthop"},{"key":"2026071510052369000_16.7.e119123.14","unstructured":"W-Dahl A , K\u00e4rrholm J , Rogmark C , et al . The swedish arthroplasty register annual report. 2025. Available: https:\/\/registercentrum.blob.core.windows.net\/slr\/r\/Ledprotesregistret-A-rsrapport-2025_1-2-8P7uE2KKW.pdf [Accessed 08 Jan 2026]."},{"key":"2026071510052369000_16.7.e119123.15","unstructured":"The swedish osteoarthritis registry. 2025. Available: https:\/\/boa.registercentrum.se\/in-english\/the-swedish-osteoarthritis-registry\/p\/By_o8GxVg [Accessed 22 Dec 2025]."},{"key":"2026071510052369000_16.7.e119123.16","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-009-9350-y"},{"key":"2026071510052369000_16.7.e119123.17","unstructured":"W-Dahl A , K\u00e4rrholm J , Rogmark C , et al . \u00c5rsrapport 2024 - svenska ledprotesregistret. 2024. Available: https:\/\/registercentrum.blob.core.windows.net\/slr\/r\/-rsrapport-2024-Svenska-Ledprotesregistret-Ze531aeCZ.pdf [Accessed 08 Jan 2026]."},{"key":"2026071510052369000_16.7.e119123.18","unstructured":"Wetterling K , J\u00f6nsson T , Kl\u00e4ssbo M , et al . The better management of patients with osteoarthritis annual report 2021. Gothenburg, 2022. Available: https:\/\/registercentrum.blob.core.windows.net\/boa\/r\/BOA-rsrapport-2021-BJx8_mMtC9.pdf [accessed 22 Dec 2025]"},{"key":"2026071510052369000_16.7.e119123.19","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-016-0117-y"},{"key":"2026071510052369000_16.7.e119123.20","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-019-00511-8"},{"key":"2026071510052369000_16.7.e119123.21","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2020-107094"},{"key":"2026071510052369000_16.7.e119123.22","doi-asserted-by":"publisher","DOI":"10.1007\/s10985-007-9036-2"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-119123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T17:05:59Z","timestamp":1784135159000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-119123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":22,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,15]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjopen-2026-119123"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-119123","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}