Citation

Rondon AJ, Tan TL, Goswami K, Shohat N, Foltz C, Courtney PM, Parvizi J. J. Am. Acad. Orthop. Surg. 2019; ePub(ePub): ePub.

Affiliation

From the Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA (Dr. Rondon, Dr. Tan, Dr. Goswami, Dr. Shohat, Dr. Foltz, Dr. Courtney, and Dr. Parvizi), and the Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel (Dr. Shohat).

Copyright

(Copyright © 2019, American Academy of Orthopaedic Surgeons)

DOI

10.5435/JAAOS-D-19-00214

PMID

31567727

Abstract

INTRODUCTION: A common question by patients considering total joint arthroplasty (TJA) is when can I return to driving. The ability to return to driving has enormous effect on the independence of the patient, ability to return to work, and other activities of daily living. With advances in accelerated rehabilitation protocols, newer studies have questioned the classic teaching of waiting 6 weeks after TJA. The goal of this prospective study was to determine specific patient predictors for return to driving and create individualized models able to estimate return to driving based on patient risk factors for both total knee arthroplasty (TKA) and total hip arthroplasty (THA).

METHODS: From July 2017 to January 2018, 554 primary TKA and 490 primary THA patients were prospectively enrolled to obtain information regarding return to driving. Patients were sent a survey every 2 weeks regarding their return to driving. Additional information regarding vehicle type, transmission, and involvement in motor vehicle accidents was collected. Bivariate analysis was done followed by the creation of a multiple linear regression models to analyze return to driving after TKA and THA.

RESULTS: The majority (98.2%, 1,025/1,044) of patients returned to driving within 12 weeks of surgery. On average, patients returned to driving at 4.4 and 3.7 weeks for TKA and THA (P < 0.001), respectively. The rate of motor vehicle accidents was 0.7% (7/1,044) within 12 weeks after surgery with no injuries reported. After multivariate analysis, baseline return to driving began at 10.9 days for TKA and 17.1 days for THA. The following predictors added additional time to return to driving for TJA: not feeling safe to drive, limited range of motion, female sex, limitations due to pain, other limitations, discharge to a rehabilitation facility, right-sided procedures, limited ability to break, preoperative anemia, and preoperative use of a cane.

DISCUSSION: Important predictors identified for return to driving were sex, joint laterality, limited ability to walk or ability to break, and feeling safe. Surgeons should consider these factors when counseling patients on their postoperative expectations regarding driving after TJA.

Language: en