|
 Recent advances in surgical techniques and anesthesia have helped
accelerate rehabilitation time, and past practices of advising
patients to wait six or eight weeks before driving may no longer
apply, the study team concludes in the Journal of the American
Academy of Orthopaedic Surgeons.
"We have guidelines and recommendations for all patients as to when
they could return to driving after their knee or hip replacement,"
said Dr. Alexander Rondon of the Rothman Orthopaedic Institute at
Thomas Jefferson University in Philadelphia, who led the study. "But
the real reason (behind the study) was we wanted objective data.
When do they actually return and why?"
The National Highway Safety Traffic Administration recommends a
three-to-four-week waiting period. Some studies have found that it
can take four to eight weeks for braking-response time to return to
normal, the study team writes.
To examine when patients actually return to driving, what factors
might predict the timing, and whether safety is impaired with
shorter wait periods, Rondon's team looked at data on 1,044
patients.
All participants had either knee- or hip-replacement surgery in 2017
or 2018 and filled out an electronic survey every two weeks for
three months following the procedure.
Patients were instructed to return to driving after they were off
pain medication and could comfortably move their leg from side to
side, but their surgeons did not specifically provide a time frame
for a return to driving.
On average, patients returned to driving 4.4 weeks after knee
replacement and 3.7 weeks after hip replacement.
For their calculations, the researchers established a baseline, or
earliest possible return to driving, of about 11 days for knee
surgery patients and 17 days for those who had hip surgery.
A variety of factors added to that time. For instance, right-sided
procedures added about two days more to the baseline.
[to top of second column] |
Use of a cane or walker before surgery, and post-surgery pain,
limited range of motion, not feeling safe to drive, discharge to a
rehabilitation facility, limited ability to brake, and other factors
predicted longer periods before returning to driving, researchers
also found.
Most surgeons do not stick to the recommendation of waiting six
weeks, and instead provide a general guideline, letting patients
decide when to get back on the road, noted Dr. Michael Alexiades, a
hip and knee surgeon at the Hospital for Special Surgery in New York
City who wasn't involved in the study.
"A lot of surgeons hesitate to give patients a definitive time to
return to driving," he said, adding there have been cases where
surgeons were sued by patients who got into accidents after resuming
driving within the time period recommended to them.
Just seven patients, or 0.7% of the study group, got into accidents
after returning to driving within 12 weeks after surgery, but there
were no reported injuries, Rondon's team found.
The surgical approach used for patients also had a significant
influence on the time taken to return to driving, the authors note.
Patients who had surgeries that approached the hip from the front,
on average, returned to driving within a little over three weeks,
compared with nearly four weeks among those who had surgeries that
involved the side or back of the hip.
Only 19 patients did not get back to driving within 12 weeks of
surgery.
"The reality of the situation is they're driving earlier today than
what is recommended, but the question as to whether they are truly
ready to return to driving in that time period still has to be
answered," Alexiades said.
SOURCE: https://bit.ly/2p7ktJv Journal of the American Academy of
Orthopaedic Surgeons, online September 18, 2019.
[© 2019 Thomson Reuters. All rights
reserved.] Copyright 2019 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
