Driving After Orthopedic Surgery

Abstract

As a result of reading this article, physicians should be able to: (1) Identify preoperative factors that may contribute to a patient's ability to return to driving after orthopedic surgery. (2) Understand the role of upper-extremity immobilization and how it may impair a patient's ability to operate a motor vehicle. (3) Recognize how various forms of lower-extremity immobilization (e.g., controlled ankle-motion boot, cast, and Aircast Walker) affect braking reaction times and total braking times. (4) Be aware of current guidelines about when it is appropriate to return to driving following arthroscopy, lower-extremity fracture, and hip and knee arthroplasty. Few guidelines are available to assist orthopedic surgeons in advising patients about when to return to driving after orthopedic surgery. A patient's surgical procedure, postoperative weight-bearing restrictions, immobilization, and other factors influence a patient's ability to drive after orthopedic surgery. Multiple studies have used driving simulators to predict when it may be safe to return to driving after orthopedic surgery. However, study conclusions and recommendations vary significantly. This article reviews the factors contributing to a patient's ability to return to driving after orthopedic surgery and reviews recommendations based on the available literature following fracture, arthroscopy, and arthroplasty.

When Can I Drive After Orthopaedic Surgery? A Systematic Review

“…Pain and limitation in motion or function of upper and lower extremities can substantially affect driving safety. Several reviews on this topic have been published [8,18,40,52], however in this study, we expanded on previously published reviews by performing a search in a systematic format, evaluating the quality of the studies, and including data from patient surveys. In addition, prior reviews focused primarily on one procedure or types of procedure, without compiling these data in a systematic format or recommendations.…”

“…Several review articles [8,18,40,52] have discussed the issue of driving after orthopaedic surgery and injuries. These articles discussed observer-reported outcome measures such as brake response time, brake force, and simulators that have been used to evaluate driving ability.…”

“…Procedures such as TKA have a substantial effect on brake response time, but the postoperative duration of this effect was reported to range from as brief as 10 days to as long as 8 weeks [40]. Similar discrepancies exist for other procedures such as THA, with one study [39] suggesting a return to driving at 6 weeks whereas others recommended 8 weeks [15,18]. To our knowledge, these controversies have not been approached using a systematic review, and the discussion of driving after orthopaedic surgery can be enhanced with inclusion of postoperative patient survey data and quality appraisal of any relevant articles.…”

Timeframe for return to driving for patients with minimally invasive knee arthroplasty is associated with knee performance on functional tests

“…Transition time was the time of lower limb moved from the accelerator pedal to the brake pedal. In the past study, it concluded that there were many factors could affect the brake reaction time, such as age [12], gender [13], visual ability [14,15], task complexity [16,17], muscle force [18], and drug intake [19]. …”

Driving after Upper or Lower Extremity Orthopaedic Surgery

“…1 2 3 The decision to resume driving involves numerous factors. 4 Regardless of the multifactorial nature of the issue, medicolegal trends, including possible litigation, are commonly putting the responsibility for the decision solely on the patient. 1 5 6 Some authors have advocated that physicians should not give detailed advice about when a patient can resume driving.…”