Introduction:   Driving restrictions after total hip arthroplasty (THA) can be inconvenient and burdensome for patients. When patients may safely be allowed to drive remains controversial. Most studies recommend 6 weeks but recent advances in surgical approach, pain management and rapid recovery may have changed this time frame. The purpose of this study was to prospectively evaluate driving safety after THA through brake reaction time

Hernandez, MD, Victor H.

Madden, Anne Marie

Ong, MD, Alvin C.

Orozco, MD, Fabio

Post, MD, Zachary D.

Victor H. Hernandez

Alvin Ong

Fabio Orozco

Anne M. Madden

Zachary Post

Crossref

The Journal of Arthroplasty

When Is It Safe for Patients to Drive after Right Total Hip Arthroplasty?

Name not available

When is it Safe for Patients to Drive after Right Total Hip Arthroplasty?

Jefferson Digital Commons

Thomas Jefferson UniversityJefferson Digital CommonsRothman Institute Conference Posters Rothman Institute3-24-2015When is it Safe for Patients to Drive after RightTotal Hip Arthroplasty?Victor H. Hernandez, MDRothman Institute at Thomas Jefferson University, victor.hernandez@rothmaninstitute.comAlvin C. Ong, MDRothman Institute at Thomas Jefferson University, alvin.ong@rothmaninstitute.comFabio Orozco, MDRothman Institute at Thomas Jefferson University, fabio.orozco@rothmaninstitute.comAnne Marie MaddenRothman Institute at Thomas Jefferson University, anne.madden@rothmaninstitute.comZachary D. Post, MDThe Rothman Institute of Orthopedics at Thomas Jefferson University Hospital, zachary.post@rothmaninstitute.comLet us know how access to this document benefits youFollow this and additional works at: http://jdc.jefferson.edu/rothinspostersPart of the Orthopedics CommonsThis Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of ThomasJefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarlypublications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers andinterested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion inRothman Institute Conference Posters by an authorized administrator of the Jefferson Digital Commons. For more information, please contact:JeffersonDigitalCommons@jefferson.edu.Recommended CitationHernandez, MD, Victor H.; Ong, MD, Alvin C.; Orozco, MD, Fabio; Madden, Anne Marie; andPost, MD, Zachary D., "When is it Safe for Patients to Drive after Right Total Hip Arthroplasty?"(2015). Rothman Institute Conference Posters. Paper 11.http://jdc.jefferson.edu/rothinsposters/11INTRODUCTIONWhen is it Safe for Patients to Drive after Right Total Hip Arthroplasty?Victor H. Hernandez MD, Alvin C. Ong MD, Fabio Orozco MD, Anne Marie Madden, Zachary D. Post MD.Investigation performed at the Rothman Institute at Thomas Jeerson University, Phladelphia, PA.MATERIALS AND METHODSDISCUSSIONTable 1: Characteristics of the 5 patients that did not reached their baselines at the 2-weeks. T=time; Pre= Pre-operative; W=Week Driving restrictions after total hip arthroplasty (THA) can be inconvenient and burdensome for patients. When patients may safely be allowed to drive remains  controversial. Most studies recommend 6 weeks but recent advances in  surgical approach, pain management and rapid recovery may  have changed this time frame.  The purpose of this study was to prospectively evaluate  driving safety after THA through brake reaction time.   Twenty nine patients who underwent right THA were pro-spectively evaluated between October 2013 and June 2014.  Driving performance was evaluated using the Brake Reaction Test (BRT) measuring brake time after a stimulus (Figure 1). All patients underwent preoperative assessment to establish a base-line.  Patients were then re-tested at 2, 4 and 6 weeks post opera-tively.  Patients were allowed to drive when the post-operative reaction time was equal to or less than the pre-operative base-line.  In addition at each testing patients were asked if they felt ready to drive. General linear repeated measurement was used for analysis. Nearly all patients were able to return to normal BRT by 2 weeks after THA. In addition, patient perception of driving ability accurately predicted return of BRT.  This represents a substantial improvement from current recommendations. These ndings have allowed us to encourage patients to re-evaluate their driving ability as soon as 2 weeks after THA.TABLE 1FIGURE 1 Of the 38 study patients, 33 (87 %) reached their baseline time by 2 weeks.  Five patients (13%) reached their baseline at 4 weeks.  There were no dierences with respect to age, gender, or the use of assistance devices.  Of the 33 patients, 24 (73%) stated that they felt ready to drive while 5 (15%) were not sure and 4 (12%) felt they were not ready.  Of the 5 patients who returned to base-line at 4 weeks, 2 patients said they thought they were ready while 3 patients did not. However, even the ve patients that did not return to their baseline by two weeks were still under the nationally recom-mended safe brake time standard of 1.25 seconds which is based upon several scientic studies looking at BRT in all types of pa-tients, surgical and non-surgical alikeRESULTSDISCUSSIONFigure 1: Brake Reaction Test (BRT) device for measuring brake time after a stimulus.Patient Age (years) Gender T - Pre T 2-W T 4-W1 75 Female 0.703 1.03 0.5662 52 Male 0.593 0.638 0.5673 51 Male 0.454 0.478 0.4494 54 Female 0.598 0.640 0.4725 64 Female 0.515 0.674 0.455

Old studies recommend 6weeks post-operative before patients can return to driving safely. This is a prospective study assessing brake reaction time (BRT) after THA. 38 patients underwent a pre-operative, 2, 4 and 6weeks post-operative BRT test. General linear repeated measurement was used. The mean pre-operative reaction time was 0.635±0.160seconds SD and 2-week was 0.576±0.137seconds SD (P=0.029); 33 patients (87%) were able to reach their baseline time by 2weeks. The remaining five patients (13%) reached their baseline at the 4-week post-operative. No differences were found with respect to age, gender, and the use of assistive devices. With new techniques in THA, most of patients return to normal times within the 2-week

Hernandez, Victor H

Ong, Alvin

Orozco, Fabio

Madden, Anne M

Post, Zachary

University of Miami: Scholarship@Miami

When is it safe for patients to drive after right total hip arthroplasty?

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When is it Safe for Patients to Drive after Right Total Hip Arthroplasty?

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