Bremsfähigkeit von Patienten nach endoprothetischer Versorgung des Hüftgelenks – Einfluss von Prothesendesign und präoperativem Status

Abstract

In conclusion, it can be confirmed that HRA patients resume normal braking capacity at an earlier stage in their rehabilitation process than THA patients. Patients recommended for HRA recover braking capacity at the latest six weeks after surgery. This capacity clearly depends on the better preoperative status of the HRA patients and is not determined by a faster recovery rate. General patient-related advantages as well as biomechanical aspects of HRA have thus no influence on the recovery rates of braking capacity during the first three months after surgery. Due to the increasing outpatient rehabilitation regime after HRA, further studies are necessary to detect the turning point after surgical impairment within the first six weeks after surgery. Concerning the THA patients we recommend a longer safety distance when driving a car for up to three months after the operation. However, patients, especially those assigned to THA, should be made aware of their most likely already existing preoperative deficit. For clinical practice a rough estimation of postoperative braking capacity seems to be possible based on group assignment (HRA/THA). Nevertheless, deviators cannot be detected by this group classification. As driving simulator systems usually are not available in hospitals, a more accurate prognosis, i.e., based on established clinical scores, would be helpful.

Effects of Right Lower Limb Orthopedic Immobilization on Braking Function: An On-The-Road Experimental Study With Healthy Volunteers

“…Moreover, a series of studies have focused on resuming driving after orthopedic surgery involving the lower limb, such as hip (11)(12)(13) and knee (14)(15)(16)(17)(18)(19) replacement, anterior cruciate ligament reconstruction (20,21), knee arthroscopy (22), operative fracture fixation (23,24), ankle arthrodesis (25), and first metatarsal osteotomy (26). In all these studies, the effect of surgery was assessed by determining the emergency braking reaction time using a driving simulator during the postoperative period.…”