When do patients drive after minimally invasive anterior hip replacements? A single surgeon experience of 212 hip arthroplasties.

Ashish Batra,Ikram Nizam,Sophia Gogos

doi:10.1051/sicotj/2018045

Abstract

Introduction: Patients desire to return to normal activities soon after hip arthroplasty, with driving often being an integral component. We aimed to determine when patients resumed driving following a minimally invasive anterior bikini hip replacement and when they returned to work.Methodology: All consecutive patients undergoing elective primary bikini hip replacements between January 2017 and April 2018 were included in the study. Patients who did not drive were excluded. A detailed questionnaire was sent to patients 3–6 weeks after surgery to record their driving status. Fifty patients were randomly selected to assess flexion at the hip, knee and ankle joints while seated in the driver's seat of their own vehicle.Results: Altogether 212 anterior bikini total hip replacements (L = 102, R = 108 and 1 bilateral one stage) were performed in 198 patients (F = 129 and M = 69) with a mean age of 69 years. A total of 76% patients returned to driving within the first 3 weeks after surgery, of which 25 (14%) resumed driving within the first post-operative week, 71 (39%) in the second week and 42 (23%) in the third week. Among them, 98.4% stated they were confident when they first started driving and 90.66% stated they were more comfortable driving after surgery than before. Employed patients returned to work within 1–79 days (mean = 24 days).Conclusion: Surgeons may allow patients to resume driving within 1 week after anterior hip replacement and return to work within 3 weeks if they are medically fit and deemed safe.

Highlights

The primary goals of total hip arthroplasties (THAs) are to relieve pain, improve quality of life and restore mobility [1], determined by the longevity of prosthesis [2] and early return to pre-morbid activities
Current literature reports a minimum 6–8-week period before patients can safely resume driving; this is based on outdated studies using posterior THA approaches, where 6–8-week waits are recommended for soft tissue recovery [5,6]
Studies of anterior hip replacements have reported early return to activities [5,7,8,9], with one study recording brake reaction times reporting a return to preoperative values by day 2 following microinvasive THA

Summary

Introduction

The primary goals of total hip arthroplasties (THAs) are to relieve pain, improve quality of life and restore mobility [1], determined by the longevity of prosthesis [2] and early return to pre-morbid activities. There is a lack of medical and legal guidelines regarding the timeline for safe resumption of driving following THA [4]. Current literature reports a minimum 6–8-week period before patients can safely resume driving; this is based on outdated studies using posterior THA approaches, where 6–8-week waits are recommended for soft tissue recovery [5,6]. Studies of anterior hip replacements have reported early return to activities [5,7,8,9], with one study recording brake reaction times reporting a return to preoperative values by day 2 following microinvasive THA.

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