Driving after Upper or Lower Extremity Orthopaedic Surgery

Abstract

Orthopaedic procedures can affect patients' ability to perform activities of daily living, such as driving automobiles or other vehicles that require coordinated use of the upper and lower extremities. Many variables affect the time needed before a patient can drive competently after undergoing orthopaedic surgery to the extremities. These variables include whether the patient underwent upper or lower extremity surgery, the country in which the patient resides, whether the right or left lower extremity is involved, whether the dominant arm is involved, whether the extremity is in a cast or brace, whether the patient has adequate strength to control the steering wheel, and whether the patient is taking pain medication. The type and complexity of the procedure also influence the speed of return of driving ability. Few studies provide definitive data on driving ability after upper or lower extremity surgery. Patients should be counseled not to drive until they can control the steering wheel and the pedals competently and can drive well enough to prevent further harm to themselves or to others. This review discusses the limited recommendations in the literature regarding driving motorized vehicles after upper or lower extremity orthopaedic surgery.

Patients Generally May Return to Driving 4 Weeks After Hip Arthroscopy and 6 Weeks After Knee Arthroscopy: A Systematic Review and Meta-analysis

“…On the basis of the inclusion and exclusion criteria, a total of 19 relevant articles remained. The articles were classified as either prospective cohort, comparative, or case-control studies 14 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ; repeated-measures design 27 ; surveys or questionnaires 6 , 28 ; literature reviews 8 , 9 , 10 , 28 , 29 ; or systematic reviews. 11 Of the remaining studies, 8 contained quantitative data on BRTs and were included in the meta-analysis.…”

“… Cooper 29 Review 2007 — — — — Driving Following Acute Lower Limb Painful Events Ho and Furlan 9 Review 2012 — — — — Driving After Upper or Lower Extremity Orthopaedic Surgery MacKenzie et al. 8 Review 2019 — — — — When Can I Drive After Orthopaedic Surgery? A Systematic Review DiSilvestro et al.…”

“…Previous reviews have combined and presented the results and recommendations from existing studies, but none have completed a metaanalysis of the existing data to search for overarching trends or patterns. 5,[8][9][10][11][12] The purpose of this study was to consolidate the evidence from the available literature and undertake a meta-analysis to provide a reference for physicians to make evidence-based recommendations to their patients regarding the return to driving after hip or knee arthroscopic procedures. We hypothesized that driving ability would be adversely affected in the postoperative period after arthroscopic procedures, making a return to driving during this period unsafe for the patient.…”

“…The effects of other orthopaedic surgical procedures, such as hip or knee arthroplasty, on the optimal return-to-driving time have also been examined. Whereas the effects of these procedures on driving ability have been better documented, 8 there is a paucity in the literature investigating the effects of hip and knee arthroscopy on driving ability. Among the studies that exist, the recommendations for the optimal time to return to driving are varied.…”

“…Previous reviews have combined and presented the results and recommendations from existing studies, but none have completed a meta-analysis of the existing data to search for overarching trends or patterns. 5 , 8 , 9 , 10 , 11 , 12 …”