Time Taken to Resume Driving Following Hip Arthroscopy

Abstract

Background: Resuming driving is a common concern among patients undergoing hip arthroscopy. The present study aimed to assess whether patients who had undergone right hip arthroscopy presented with poorer driving performance than patients with normal hips and to analyze the time required to regain preoperative driving performance. Methods: Forty-seven patients who had undergone right hip arthroscopy and consented to our test protocol were included in this study. Using an immersive driving simulator, the patients were tested for their brake reaction time (BRT), total brake time (TBT), and brake pedal depression (BPD) preoperatively and postoperatively. The first postoperative assessments were conducted when the patients could comfortably sit on the driving seat, and the follow-up assessments were conducted for 6 consecutive weeks at weekly intervals. The patients were divided into the following two groups based on the type of surgery that they underwent: the femoroacetabular impingement (FAI) surgery group and the simple hip arthroscopy (SA) group. Twenty healthy volunteers underwent driving assessments thrice at weekly intervals and constituted the control group. The braking parameters were compared between preoperative and postoperative measurements and among the FAI surgery, SA, and control groups. Results: The preoperative braking parameters of the patients who underwent arthroscopy did not differ significantly from those of the controls (p=0.373, 0.763, and 0.447 for the BRT, TBT, and BPD, respectively). All braking parameters returned to normal in 2 weeks in the FAI surgery group and in 1 week in the SA group. Conclusions: Our study suggests that the driving performance of patients who underwent right hip arthroscopy is comparable to that of individuals with normal hips and that the braking parameters may normalize to the preoperative state at 1 week after SA and 2 weeks after FAI surgery.

Return to Driving After Hip Arthroscopy: A Systematic Review and Meta-analysis

“…Of these, 142 patients were treated for FAI, and 18 patients had undergone other “simple” hip arthroscopic procedures (“simple”—defined by authors as <60 minutes in duration, without osseous correction or labral repair) (detailed in Table 1 ). 24 The mean weighted age was 33.7 ± 9.0 years, 47.5% of the patients were female, and the right hip was affected in 71.2%. Laterality was not reported in the 59 patients of Balazs et al 3 and 21 patients of Yoshida et al 6 We contacted the corresponding authors to recover these data, and the authors kindly provided the requested information.…”

“…Five articles were included per criteria. 3 , 24 , 34 , 45 , 46 Four studies were of prospective case-control cohorts (evidence level 2) 3 , 24 , 34 , 45 and 1 of a prospective cohort (evidence level 3). 46 Included studies were published between the years 2017 and 2021.…”

“…The same results were obtained by Rounds et al, 41 who performed a 2-week follow-up prospective cohort study with a sample of 4 patients with right-sided and 4 with left-sided hip arthroscopies (without mention of surgery type). In another study that was included in this review, Jo et al 24 analyzed 18 patients who underwent other types of hip arthroscopies (Table 1) and found that BRT returned to preoperative levels 1 week after surgery. The ability to drive safely requires an efficient reaction time, from initiation of stimulus ordering to brake, to foot movement off the accelerator and initial contact with the brake pedal.…”

“…Patients experience pain in the acute postoperative period, and this could influence BRT by prolonging FMT. Most of the included studies in our review 3 , 24 , 34 tracked patients’ pain scores before driving simulation sessions using the visual analog scale (VAS). Jo et al 24 and Balazs et al 3 found no significant correlation between changes in braking parameters and VAS in the postoperative period, meaning that changes in postoperative pain score did not influence driving performance.…”

“…The use of opioid medications in the acute postoperative period is common and can alter alertness, influencing BRT by prolonging IRT. Most of the included studies 24 , 34 , 46 refrained from prescribing opioid medications several days or the morning before driving simulation sessions. Balazs et al 3 tracked the use of analgetic medications prescribed per each driving session and found no association between changes in braking parameters and the use of postoperative opiate analgesics.…”