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

Abstract

BackgroundThis study hopes to establish the timeframe for a safe return to driving under different speed conditions for patients after minimally invasive total knee arthroplasty and further explores how well various kinds of functional tests on knee performance can predict the patients’ braking ability.Methods14 patients with right knee osteoarthritis were included in the present study and instructed to perform three simulated driving tasks at preoperative, 2 weeks postoperative and 4 weeks postoperative.ResultsThe results showed that the total braking time at 4 week postoperative has attained the preoperative level at the driving speed 50 and 70 km/hr but not at the driving speed 90 km/hr. It had significantly improving in knee reaction time and maximum isometric force at 4 weeks postoperative. Besides, there was a moderate to high correlation between the scores of the step counts and the total braking time.ConclusionsSummary, it is recommended that driving may be resumed 4 weeks after a right knee replacement but had to drive at low or moderate speed and the best predictor of safety driving is step counts.

When Can I Drive After Orthopaedic Surgery? A Systematic Review

“…A similar correlation was found in these patients between stepping and standing tests and brake response time [22]. Patients with a right TKA had normal brake response times and total brake times 2 to 8 weeks postoperatively [9,28,36,37,42,50,57] and normal brake response times 0 to 3 weeks after a left TKA [36,37,41,50,57]. Data showed that a step test was the best predictor of safety when correlated with total brake time after TKA [28].…”

“…Brake response time is the amount of time elapsed between the appearance of a stimulus and when contact was made with a brake pedal. Total brake time was reported in six articles [13,26,28,30,48,60]. Total brake time is the amount of time elapsed between the appearance of a stimulus and when a brake pedal is fully depressed.…”

“…Patients with a right TKA had normal brake response times and total brake times 2 to 8 weeks postoperatively [9,28,36,37,42,50,57] and normal brake response times 0 to 3 weeks after a left TKA [36,37,41,50,57]. Data showed that a step test was the best predictor of safety when correlated with total brake time after TKA [28]. Patients with THAs had normal brake response times, total brake times, and brake forces 2 to 8 weeks after right-sided procedures [15,23,30,39,53] and 1 to 8 weeks after left-sided procedures [15,30,39].…”

What Is the Evidence on Which Physicians Can Rely to Advise Patients When They May Resume Driving after TKA? A Systematic Literature Review

“…Furthermore, only three of the included studies [35,37,42] performed sample size justification analysis (statistical power). Five studies [33,34,[38][39][40] did not provide information on dropouts and their reasons.…”

“…In three studies [34,38,39] the patients performed the BRT test-trials in more than one task. In two studies by Marques et al [38,39] the patients performed a simple and a more complex task, with the task complexity being manipulated by adding a second movement to the first BRT task.…”