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

Marques, Carlos J.; Barreiros, João; Cabri, Jan

doi:10.3390/jfmk3010008

Cited by 3 publications

(4 citation statements)

References 46 publications

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“…Goodwin et al [15], on the other hand, recommend 10 days to 8 weeks of rest following a right-sided TKA and 6 to 8 weeks of rest following a right-sided THA before resumption of driving. When it comes to the brake reaction time a similar picture is painted: Marques et al [16] recorded 44±19 days for the patients to reach their preoperative brake reaction time following a right-sided TKA and 20±15 days following a left-sided TKA. Nizam et al [17], however, recorded a Median of 3 weeks following a TKA, regardless of side.…”

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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Driving After Total Knee and Hip Arthroplasty - an Observational Study From the Perspective of Rehabilitative Orthopaedic Therapy

Lazar¹,

Edelmann²,

Lohmann

et al. 2021

Preprint

View full text Add to dashboard Cite

Objective: Considering the legal stipulations in Germany regarding fitness to drive a motor vehicle, the aim of this study is to find out when patients with a total knee arthroplasty (TKA) or total hip arthroplasty (THA) actually take up driving again after surgery; how the replaced joint, side, gender, place of residence and physician’s recommendations, influences the patient in making the decision to start driving again.Background: For a large proportion of the population, especially those residing in the countryside, the use of a car for daily activities is indispensable. Following a TKA or THA procedure, the overseeing physician will usually recommend refraining from driving, sometimes up to 12 weeks after surgery with a major social and economical impact on patient’s life. Methods: 92 eligible participants, contained within the frame of a prospective experimental observational study, were contacted via telephone 12 weeks after surgery and interviewed using a structured questionnaire. The answers were statistically analysed using SPSS®.Discussion: There were statistically significant differences regarding operated side, gender and place of residence. Male patients drove in the 6th and 7th postoperative week, while female patients drove in the 8th and 9th postoperative week. For 58.6% of patients the reasoning for the first post-operative drive was medical: the journey to physiotherapy or to a doctor’s appointment. TKA impaired patients the most. Patients recovering from a TKA drive considerably later. Patients recovering from a right sided TKA have an increased risk by a factor of nine, not to become an “early driver”. Female patients who underwent TKA had an increased risk by a factor of 21, of becoming a “late driver”. Conclusions: The rehabilitation following a right sided TKA proved a challenge with regard to the reuptake of driving. This should be taken into account when planning the course of therapy for patients who are driving regulary. Female patients could benefit from special training. Trial registration: DRKS00018693. Registered 20 September 2019 https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00018693

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Driving After Total Knee and Hip Arthroplasty - an Observational Study From the Perspective of Rehabilitative Orthopaedic Therapy

Lazar¹,

Edelmann²,

Lohmann

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…When it comes to the brake reaction time a similar picture is painted: Marques et al recorded 44 ± 19 days for the patients to reach their preoperative brake reaction time following a right-sided TKA and 20 ± 15 days following a left-sided TKA [ 17 ]. Nizam et al, however, recorded a Median of 3 weeks following a TKA, regardless of side [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical site, gender, and place of residence influence the time to resume driving after total joint arthroplasty

Lazar

Edelmann²,

Awiszus

et al. 2021

Arch Physiother

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Background For a large proportion of the population, especially those residing in the countryside, the use of a car for daily activities is indispensable. Following a TKA or THA procedure, the overseeing physician will usually recommend refraining from driving, sometimes up to 12 weeks after surgery with a major social and economical impact on patient’s life. Objective Considering the legal stipulations in Germany regarding fitness to drive a motor vehicle, the aim of this study is to determine the time point when patients after total knee arthroplasty (TKA) or total hip arthroplasty (THA) take up driving again postoperatively. Further, we assessed the replaced joint, side, gender, place of residence and physician’s recommendations influencing the patient in making the decision to start driving again. Methods 92 eligible participants, contained within the frame of a prospective experimental observational study, were contacted via telephone 12 weeks after surgery and interviewed using a structured questionnaire. The answers were statistically analysed using SPSS® Version 26 for Windows. Results Male participants resumed driving between the 6th and 7th week post-surgery, female participants resumed driving between the 8th and 9th week post-surgery. For 58.6% of patients the reason for the first post-operative use of a vehicle was medical: the journey to physical therapy or to a doctor’s appointment. There were statistically significant differences regarding operated side, gender and place of residence. TKA impaired patients the most. Patients recovering from a TKA drove considerably later. Patients recovering from a right sided TKA had an increased risk (9 times) not to become an “early driver”. Female patients who underwent TKA had an increased risk by a factor of 21 of becoming a “late driver”. In the ageing population, surgeons, physical therapists and rehabilitation professionals need to consider new approaches in providing options for patients’ mobility. Interestingly, there is a different need for early use of own vehicle in rural regions whereas in cities patients start driving later. There are clear differences between gender and surgical site. Conclusions The rehabilitation following a right sided TKA proved a challenge with regard to the reuptake of driving. This should be taken into account when planning the course of therapy for patients who are driving regulary. Female patients could benefit from special training. Trial registration retrospectively registered, DRKS00018693 https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID=DRKS00018693.

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“…The authors of this paper have focused on the more recent published works and were able to nd that there is a very large bandwidth of recommendations when to reuptake driving after TKA or THA, ranging from two days up to 8 weeks after surgery. [4,5,11,12,13,14,15,16,17,18] In Germany, in some cases the recommendation to restrain from driving after TKA or THA procedures is 12 weeks after surgery. We've decided to take the 12 weeks timeframe as the maximum amount of recovery time after a TKA or THA procedure, with no further complications, and set out to nd to what extent patients take said recommendations into account when returning to motor vehicle driving after surgery.…”

Section: Introductionmentioning

confidence: 99%

Driving after total knee and hip arthroplasty - an observational study from the perspective of rehabilitative orthopaedic therapy

Lazar¹,

Edelmann²,

Awiszus

et al. 2021

Preprint

View full text Add to dashboard Cite

Objective Considering the legal stipulations in Germany regarding fitness to drive a motor vehicle, the aim of this study is to find out when patients with a TKA or THA actually take up driving again after surgery; how the replaced joint, side, gender, place of residence and physician’s recommendations, influences the patient in making the decision to start driving again. Background For a large proportion of the population, especially those residing in the countryside, the use of a car for daily activities is indispensable. Following a TKA or THA procedure, the overseeing physician will usually recommend refraining from driving, sometimes up to 12 weeks after surgery with a major social and economical impact on patient’s life. Methods 92 eligible participants, contained within the frame of a prospective experimental observational study, were contacted via telephone 12 weeks after surgery and interviewed using a structured questionnaire. The answers were statistically analysed using SPSS®. Discussion There were statistically significant differences regarding operated side, gender and place of residence. Male patients drove in the 6th and 7th postoperative week, while female patients drove in the 8th and 9th postoperative week. For 58.6% of patients the reasoning for the first post-operative drive was medical: the journey to physiotherapy or to a doctor’s appointment. TKA impaired patients the most. Patients recovering from a TKA drive considerably later. Patients recovering from a right sided TKA have an increased risk by a factor of nine, not to become an “early driver”. Female patients who underwent TKA had an increased risk by a factor of 21, of becoming a “late driver”. Conclusions The rehabilitation following a right sided TKA proved a challenge with regard to the reuptake of driving. This should be taken into account when planning the course of therapy for patients who are regular drivers. Female patients could benefit from special training. Trial registration: DRKS00018693. Registered 20 September 2019 https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00018693

show abstract

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

Cited by 3 publications

References 46 publications

Driving After Total Knee and Hip Arthroplasty - an Observational Study From the Perspective of Rehabilitative Orthopaedic Therapy

Driving After Total Knee and Hip Arthroplasty - an Observational Study From the Perspective of Rehabilitative Orthopaedic Therapy

Surgical site, gender, and place of residence influence the time to resume driving after total joint arthroplasty

Driving after total knee and hip arthroplasty - an observational study from the perspective of rehabilitative orthopaedic therapy

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