Driving after Hip Replacement

Driving after Hip Replacement

The inability to drive after a total hip replacement remains one of the major hurdles in a patient’s independence after surgery. Historically, patients have been advised to refrain from driving for 4-6 weeks. It is almost impossible to imagine life without the ability to drive for most residents of the United States where public transportation is not readily available. In a prospective study, researchers found that patients had begun driving as soon as about two weeks after surgery[1]. In my practice, I often find patients drive themselves to their two week appointment after surgery.

Orthopedic surgeons have to consider safety and potential legal issues before allowing a patient to drive. The most important concern for surgeons allowing hip replacement patients to drive is their ability to apply the brake in case of emergency. In literature, the ability to resume driving is measured in the form of “Brake Response Time” (BRT) i.e. from the moment you see that you need to stop or slow down to the time you are actually able to apply the brake. There is a significant variation in the time it takes for patients to achieve preoperative brake response time. It varies between 2 weeks to up to 4 weeks after surgery[2]. Patients have achieved baseline brake response time as early as 2 weeks after a right hip replacement[3].

Overall, it seems patients are able to resume driving sooner after a hip replacement than a knee replacement. In my experience, patients can resume driving an automatic transmission automobile 2 weeks after left hip arthroplasty and 3 weeks after right hip arthroplasty. Modern minimally invasive arthroplasty, especially Anterior Hip Replacement, may allow for a sooner return to driving. However, it should be noted that driving is a complex function and involves alert mental and functional physical capabilities. Patients should be relatively pain free so they are not distracted by pain. They should also not be drowsy or sleepy due to medications, especially narcotics. There remains a legal issue of liability in case a patient gets in an accident. There are no clear guidelines as to when it’s legally acceptable to drive.

In summary, I think it is acceptable to start driving 2 weeks after hip replacement provided the patient is alert and comfortable. Initially, patients should drive shorter distances until they become fully acclimated to the new prosthesis.

References:

1. Rondon AJ, Tan TL, Goswami K, Shohat N, Foltz C, Courtney PM, et al. When Can I Drive? Predictors of Returning to Driving After Total Joint Arthroplasty. J Am Acad Orthop Surg. 2019;

2. Hernandez VH, Ong A, Orozco F, Madden AM, Post Z. When Is It Safe for Patients to Drive After Right Total Knee Arthroplasty? J Arthroplasty. 2016;31:2495–8.

3. van der Velden CA, Tolk JJ, Janssen RPA, Reijman M. When is it safe to resume driving after total hip and total knee arthroplasty? a meta-analysis of literature on post-operative brake reaction times. Bone Jt J. 2017;99-B:566–76.