Abstract
BackgroundAlthough the numbers of total knee arthroplasty (TKA) are increasing, there is only a small number of studies investigating driving safety after TKA. The parameter 'Brake Response Time (BRT)' is one of the most important criteria for driving safety and was therefore chosen for investigation.The present study was conducted to test the hypotheses that patients with right- or left-sided TKA show a significant increase in BRT from pre-operative (pre-op, 1 day before surgery) to post-operative (post-op, 2 weeks post surgery), and a significant decrease in BRT from post-op to the follow-up investigation (FU, 8 weeks post surgery). Additionally, it was hypothesized that the BRT of patients after TKA is significantly higher than that of healthy controls.Methods31 of 70 consecutive patients (mean age 65.7 +/- 10.2 years) receiving TKA were tested for their BRT pre-op, post-op and at FU. BRT was assessed using a custom-made driving simulator. We used normative BRT data from 31 healthy controls for comparison.ResultsThere were no significant increases between pre-op and post-op BRT values for patients who had undergone left- or right-sided TKA. Even the proportion of patients above a BRT threshold of 700 ms was not significantly increased postop. Controls had a BRT which was significantly better than the BRT of patients with right- or left-sided TKA at all three time points.ConclusionThe present study showed a small and insignificant postoperative increase in the BRT of patients who had undergone right- or left-sided TKA. Therefore, we believe it is not justified to impair the patient's quality of social and occupational life post-surgery by imposing restrictions on driving motor vehicles beyond an interval of two weeks after surgery.
Highlights
The numbers of total knee arthroplasty (TKA) are increasing, there is only a small number of studies investigating driving safety after TKA
In two studies concerning the effects of TKA on Brake response time (BRT) [7,10] the following was reported: Spalding et al [7] measured the BRT of patients receiving TKA and reported recovery of BRT after 8 weeks following TKA performed on the right leg
Pierson et al [10] investigated 31 patients before and after TKA, found significantly reduced BRT after 6 weeks and suggested that patients should be permitted to drive after this time
Summary
The numbers of total knee arthroplasty (TKA) are increasing, there is only a small number of studies investigating driving safety after TKA. The elderly are dependent on their driving abilities in order to execute activities of daily living [6] Those scheduled for TKA frequently wish to know when they can resume driving after the operation. Pierson et al [10] investigated 31 patients before and after TKA, found significantly reduced BRT after 6 weeks and suggested that patients should be permitted to drive after this time. It is not clear whether their results may be extrapolated to patients driving a car with a coupler because Pierson et al used a test device with two pedals and permitted braking with the right or the left foot. 13 of their patients had undergone simultaneous bilateral TKA
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