Social work-supported strategies to reduce postoperative readmissions in orthopedic surgery: A narrative review

Postoperative readmissions in orthopedic surgery remain a persistent cause of patient morbidity and increased healthcare costs, many of which are preventable through improved care coordination. Social workers are uniquely positioned to address psychosocial and structural barriers influencing postoperative recovery. This narrative review examined peer-reviewed literature published between 2000 and 2025 using PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar. Eligible studies included U.S.-based articles evaluating social work roles in discharge planning, transitional care, case management, or community linkage programs aimed at reducing readmissions following orthopedic procedures. Across the literature, social work-supported interventions, such as early comprehensive needs assessments, structured discharge planning, involvement of caregivers, coordination with rehabilitation and home-health services, and facilitation of transportation or housing resources, were consistently associated with reduced readmissions and unplanned care utilization. Embedding social workers within multidisciplinary teams improved communication, postoperative instruction comprehension, follow-up adherence, and patient satisfaction. Benefits were most pronounced among high-risk groups, including older adults, socially isolated patients, and individuals facing significant social determinants of health-related barriers. Integrating social workers into perioperative orthopedic care pathways can meaningfully improve discharge readiness and postoperative safety. Orthopedic teams can apply these findings by adopting standardized social needs screening, involving social workers early in hospitalization, and strengthening partnerships with community organizations. These strategies provide practical, scalable pathways for reducing preventable readmissions and advancing patient-centered care.