Driving after Knee Replacement

Inability to drive after total knee replacement remains one of the major hurdle in patient’s independence after surgery. Historically patients have been advised to refrain from driving for 4-6weeks. Life without driving is almost impossible to imagine in most of the geographic region of the United States. While patients are homebound and dependent for daily needs, the family members or the friends are inconvenienced to drive the patient for physical therapy and doctors appointments. Many patients could resume sedentary type of jobs if they’re able to drive to their workplace.


Orthopedic surgeons have to consider safety and potentially legal issues before allowing patient to drive. The most important concern for surgeons to allow the patient to drive after knee replacement is about their ability to apply break in case they need to apply emergency brake. In literature ability to resume driving is measured in form of “Break 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 break. There is significant variation in time it takes for patient to achieve preoperative break response time. It varies between 2 weeks to up to 6 weeks from the surgery[1][2]. It also depends on whether it’s left knee or right knee replacement. Over 300 studies have been published on this issue but this matter is far from conclusion[3].


There is a general consensus in literature that patient can resume driving an automatic transmission automobile 2 weeks after left knee replacement and 4 weeks after right knee replacement. However, it should be noted that driving is a complex function and involves alert mental and functional physical capabilities. Patients should to 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 patient gets in an accident. There are no clear guidelines as to when it’s legally acceptable to drive.


In conclusion, it is acceptable to start driving 2 weeks after left knee and 4 weeks after right knee replacement provided patient is alert and comfortable. Initially patient should drive shorter distances until they become fully acclimatized to new prosthesis.


References:

1. 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.

2. Pierson JL, Earles DR, Wood K. Brake response time after total knee arthroplasty: when is it safe for patients to drive? J Arthroplasty. 2003;18:840–3.

3. Hartman J, Thornley P, Oreskovich S, Adili A, Bedi A, Khan M. Braking Time Following Total Knee Arthroplasty: A Systematic Review. J Arthroplasty. 2018;33:284-290.e1.

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