Driving reaction time following periacetabular osteotomy

Abstract

Introduction: Periacetabular osteotomy (PAO) is increasingly being used to treat young adults with symptomatic hip dysplasia. Currently there is a lack of evidence to guide return to driving after this procedure. This study aimed to identify the length of time required after a Periacetabular Osteotomy procedure before a patient can safely return to driving. Methods: All patients undergoing PAO were assessed for suitability for the study. Inclusion criteria were: currently driving with a valid licence; and being able to attend follow-up assessment. Baseline driving reaction time was assessed using a driving simulator preoperatively. The simulation was repeated 5 times for each patient and reaction times recorded (Thinking time, Action time and Total reaction time for braking at 30 mph). The driving simulation was repeated using the same methods at 6 weeks and 12 weeks postoperatively. Pre- and postoperative times were compared. Results: 26 patients were included (24 females, 2 males) with a mean age of 32 (range 19–50) years. The mean preoperative times were: Thinking time 0.48, Action time 0.21, Total time 0.69 seconds. At 6 weeks postoperatively, mean Action time increased to 0.26 seconds ( p = 0.012) and mean Total time increased to 0.78 seconds ( p = 0.013). By 12 weeks post procedure, there was no significant difference in reaction times compared to baseline (mean Thinking time 0.47 seconds, Action time 0.23, Total time 0.72; p > 0.05). Conclusions: Most patients may not be safe to drive at 6 weeks following PAO procedures but should be safe to drive at 12 weeks postoperatively. Individual patient factors should also be taken into consideration.

Comparison of Two Surgical Approaches for Periacetabular Osteotomy: A Retrospective Study of Patients with Developmental Dysplasia of the Hip

“…However, due to the deep osteotomy site and the wide distribution of blood vessels and nerves around the hip joint, this operation demands a high level of surgical skill from the operator, has a prolonged learning curve, and is susceptible to severe surgical complications. 4,5 To address these challenges, surgeons are continually exploring novel surgical approaches to increase surgical success rates and minimize surgical complications. 6 Bernese PAO, as described by Ganz et al, is frequently utilized as a reorientation osteotomy in adolescents.…”

“…This procedure moves the hip joint's rotation center inwards, enhancing acetabular coverage, increasing the contact area of the weight‐bearing joint surface, and reducing cartilage stress on the acetabulum and the weight‐bearing surface of the femoral head, thereby preventing and delaying the onset of hip arthritis. However, due to the deep osteotomy site and the wide distribution of blood vessels and nerves around the hip joint, this operation demands a high level of surgical skill from the operator, has a prolonged learning curve, and is susceptible to severe surgical complications 4,5 . To address these challenges, surgeons are continually exploring novel surgical approaches to increase surgical success rates and minimize surgical complications 6 …”