When Can I Drive After Orthopaedic Surgery? A Systematic Review
Background Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, t...
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| Veröffentlicht in: | Clinical orthopaedics and related research 2016-12, Vol.474 (12), p.2557-2570 |
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| creator | DiSilvestro, Kevin J. Santoro, Adam J. Tjoumakaris, Fotios P. Levicoff, Eric A. Freedman, Kevin B. |
| description | Background
Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, to estimate when patients can safely resume driving after surgery, and patient survey data describing when patients report a return to driving, but they do not all agree. We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive.
Questions/purposes
Based on the available evidence, we sought to determine when patients can safely return to driving after (1) lower extremity orthopaedic surgery and injuries; (2) upper extremity orthopaedic surgery and injuries; and (3) spine surgery.
Methods
A search was performed using PubMed and EMBASE
®
, with a list of 20 common orthopaedic procedures and the words “driving” and “brake”. Selection criteria included any article that evaluated driver safety or time to driving after major orthopaedic surgery or immobilization using observer-reported outcome measures or survey data. A total of 446 articles were identified from the initial search, 48 of which met inclusion criteria; abstract-only publications and non-English-language articles were not included. The evidence base includes data for driving safety on foot, ankle, spine, and leg injuries, knee and shoulder arthroscopy, hip and knee arthroplasty, carpal tunnel surgery, and extremity immobilization. Thirty-four of the articles used observer-reported outcome measures such as total brake time, brake response time, driving simulator, and standardized driving track results, whereas the remaining 14 used survey data.
Results
Observer-reported outcome measures of total brake time, brake response time, and brake force postoperatively suggested patients reached presurgical norms 4 weeks after right-sided procedures such as TKA, THA, and ACL reconstruction and approximately 1 week after left-sided TKA and THA. The collected survey data suggest patients resumed driving 1 month after right-sided and left-sided TKAs. Patients who had THA reported returning to driving between 6 days and 3 months postoperatively. Observer-reported outcome measures showed that patients’ driving abilities often are impaired when wearing an immobilizing cast above |
| doi_str_mv | 10.1007/s11999-016-5007-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5085934</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1837322288</sourcerecordid><originalsourceid>FETCH-LOGICAL-c573t-d0e57d623451fc6385dd51a69d554bd5e87deb2441e838adea7c59cc86b25dcc3</originalsourceid><addsrcrecordid>eNqNkUtLAzEUhYMotlZ_gBsZcONmNI_JJNkopb4KguAD3YU0ubVT2pmazFT6781QFRUEV-HmnntObj6E9gk-JhiLk0CIUirFJE95rFO1gbqEU5kSwugm6mKMVaooee6gnRCmsWQZp9uoQ0WmaC5lF509TaBMBqZMhsm5L5aQ9Mc1-OTW15NqYcAVNrlv_Av41VnST-5XoYa5qePtHSwLeNtFW2MzC7D3cfbQ4-XFw-A6vbm9Gg76N6nlgtWpw8CFy2nMJ2ObM8md48TkynGejRwHKRyMaJYRkEwaB0ZYrqyV-YhyZy3rodO176IZzcFZKGtvZnrhi7nxK12ZQv_slMVEv1RLzbHkimXR4OjDwFevDYRaz4tgYTYzJVRN0EQywSilUv5HmimVk7hODx3-kk6rxpfxJ1pV9BNStNlkrbK-CsHD-OvdBOuWpF6T1JGkbklqFWcOvi_8NfGJLgroWhBiq4yAvkX_6foOAcmoCA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1833227874</pqid></control><display><type>article</type><title>When Can I Drive After Orthopaedic Surgery? A Systematic Review</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>DiSilvestro, Kevin J. ; Santoro, Adam J. ; Tjoumakaris, Fotios P. ; Levicoff, Eric A. ; Freedman, Kevin B.</creator><creatorcontrib>DiSilvestro, Kevin J. ; Santoro, Adam J. ; Tjoumakaris, Fotios P. ; Levicoff, Eric A. ; Freedman, Kevin B.</creatorcontrib><description>Background
Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, to estimate when patients can safely resume driving after surgery, and patient survey data describing when patients report a return to driving, but they do not all agree. We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive.
Questions/purposes
Based on the available evidence, we sought to determine when patients can safely return to driving after (1) lower extremity orthopaedic surgery and injuries; (2) upper extremity orthopaedic surgery and injuries; and (3) spine surgery.
Methods
A search was performed using PubMed and EMBASE
®
, with a list of 20 common orthopaedic procedures and the words “driving” and “brake”. Selection criteria included any article that evaluated driver safety or time to driving after major orthopaedic surgery or immobilization using observer-reported outcome measures or survey data. A total of 446 articles were identified from the initial search, 48 of which met inclusion criteria; abstract-only publications and non-English-language articles were not included. The evidence base includes data for driving safety on foot, ankle, spine, and leg injuries, knee and shoulder arthroscopy, hip and knee arthroplasty, carpal tunnel surgery, and extremity immobilization. Thirty-four of the articles used observer-reported outcome measures such as total brake time, brake response time, driving simulator, and standardized driving track results, whereas the remaining 14 used survey data.
Results
Observer-reported outcome measures of total brake time, brake response time, and brake force postoperatively suggested patients reached presurgical norms 4 weeks after right-sided procedures such as TKA, THA, and ACL reconstruction and approximately 1 week after left-sided TKA and THA. The collected survey data suggest patients resumed driving 1 month after right-sided and left-sided TKAs. Patients who had THA reported returning to driving between 6 days and 3 months postoperatively. Observer-reported outcome measures showed that patients’ driving abilities often are impaired when wearing an immobilizing cast above or below the elbow or a shoulder sling on their dominant arm. Patients reported a return to driving on average 2 months after rotator cuff repair procedures and approximately 1–3 months postoperatively for total shoulder arthroplasties. Most patients with spine surgery had normal brake response times at the time of hospital discharge. Patients reported driving 6 weeks after total disc arthroplasty and anterior cervical discectomy and fusion procedures.
Conclusions
The available evidence provides a best-case scenario for when patients can return to driving. It is important for observer-reported outcome measures to have normalized before a patient can consider driving, but other factors such as strength, ROM, and use of opioid analgesics need to be considered. This review can provide a guideline for when physicians can begin to consider evaluating these other factors and discussing a return to driving with patients. Survey data suggest that patients are returning to driving before observer-reported outcome measures have normalized, indicating that physicians should tell patients to wait longer before driving. Further research is needed to correlate observer-reported outcome measures with adverse events, such as motor vehicle accidents, and clinical tests that can be performed in the office.
Level of Evidence
Level III, therapeutic study</description><identifier>ISSN: 0009-921X</identifier><identifier>EISSN: 1528-1132</identifier><identifier>DOI: 10.1007/s11999-016-5007-9</identifier><identifier>PMID: 27492688</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Accidents, Traffic - prevention & control ; Automobile Driving ; Biomechanical Phenomena ; Conservative Orthopedics ; Humans ; Lower Extremity - injuries ; Lower Extremity - physiopathology ; Lower Extremity - surgery ; Medicine ; Medicine & Public Health ; Orthopedic Procedures - adverse effects ; Orthopedics ; Postoperative Complications - etiology ; Range of Motion, Articular ; Reaction Time ; Recovery of Function ; Risk Factors ; Spine - physiopathology ; Spine - surgery ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Systematic Review ; Time Factors ; Treatment Outcome ; Upper Extremity - injuries ; Upper Extremity - physiopathology ; Upper Extremity - surgery</subject><ispartof>Clinical orthopaedics and related research, 2016-12, Vol.474 (12), p.2557-2570</ispartof><rights>The Association of Bone and Joint Surgeons® 2016</rights><rights>The Association of Bone and Joint Surgeons 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c573t-d0e57d623451fc6385dd51a69d554bd5e87deb2441e838adea7c59cc86b25dcc3</citedby><cites>FETCH-LOGICAL-c573t-d0e57d623451fc6385dd51a69d554bd5e87deb2441e838adea7c59cc86b25dcc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5085934/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5085934/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,313,314,727,780,784,792,885,27922,27924,27925,41488,42557,51319,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27492688$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DiSilvestro, Kevin J.</creatorcontrib><creatorcontrib>Santoro, Adam J.</creatorcontrib><creatorcontrib>Tjoumakaris, Fotios P.</creatorcontrib><creatorcontrib>Levicoff, Eric A.</creatorcontrib><creatorcontrib>Freedman, Kevin B.</creatorcontrib><title>When Can I Drive After Orthopaedic Surgery? A Systematic Review</title><title>Clinical orthopaedics and related research</title><addtitle>Clin Orthop Relat Res</addtitle><addtitle>Clin Orthop Relat Res</addtitle><description>Background
Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, to estimate when patients can safely resume driving after surgery, and patient survey data describing when patients report a return to driving, but they do not all agree. We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive.
Questions/purposes
Based on the available evidence, we sought to determine when patients can safely return to driving after (1) lower extremity orthopaedic surgery and injuries; (2) upper extremity orthopaedic surgery and injuries; and (3) spine surgery.
Methods
A search was performed using PubMed and EMBASE
®
, with a list of 20 common orthopaedic procedures and the words “driving” and “brake”. Selection criteria included any article that evaluated driver safety or time to driving after major orthopaedic surgery or immobilization using observer-reported outcome measures or survey data. A total of 446 articles were identified from the initial search, 48 of which met inclusion criteria; abstract-only publications and non-English-language articles were not included. The evidence base includes data for driving safety on foot, ankle, spine, and leg injuries, knee and shoulder arthroscopy, hip and knee arthroplasty, carpal tunnel surgery, and extremity immobilization. Thirty-four of the articles used observer-reported outcome measures such as total brake time, brake response time, driving simulator, and standardized driving track results, whereas the remaining 14 used survey data.
Results
Observer-reported outcome measures of total brake time, brake response time, and brake force postoperatively suggested patients reached presurgical norms 4 weeks after right-sided procedures such as TKA, THA, and ACL reconstruction and approximately 1 week after left-sided TKA and THA. The collected survey data suggest patients resumed driving 1 month after right-sided and left-sided TKAs. Patients who had THA reported returning to driving between 6 days and 3 months postoperatively. Observer-reported outcome measures showed that patients’ driving abilities often are impaired when wearing an immobilizing cast above or below the elbow or a shoulder sling on their dominant arm. Patients reported a return to driving on average 2 months after rotator cuff repair procedures and approximately 1–3 months postoperatively for total shoulder arthroplasties. Most patients with spine surgery had normal brake response times at the time of hospital discharge. Patients reported driving 6 weeks after total disc arthroplasty and anterior cervical discectomy and fusion procedures.
Conclusions
The available evidence provides a best-case scenario for when patients can return to driving. It is important for observer-reported outcome measures to have normalized before a patient can consider driving, but other factors such as strength, ROM, and use of opioid analgesics need to be considered. This review can provide a guideline for when physicians can begin to consider evaluating these other factors and discussing a return to driving with patients. Survey data suggest that patients are returning to driving before observer-reported outcome measures have normalized, indicating that physicians should tell patients to wait longer before driving. Further research is needed to correlate observer-reported outcome measures with adverse events, such as motor vehicle accidents, and clinical tests that can be performed in the office.
Level of Evidence
Level III, therapeutic study</description><subject>Accidents, Traffic - prevention & control</subject><subject>Automobile Driving</subject><subject>Biomechanical Phenomena</subject><subject>Conservative Orthopedics</subject><subject>Humans</subject><subject>Lower Extremity - injuries</subject><subject>Lower Extremity - physiopathology</subject><subject>Lower Extremity - surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedic Procedures - adverse effects</subject><subject>Orthopedics</subject><subject>Postoperative Complications - etiology</subject><subject>Range of Motion, Articular</subject><subject>Reaction Time</subject><subject>Recovery of Function</subject><subject>Risk Factors</subject><subject>Spine - physiopathology</subject><subject>Spine - surgery</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Systematic Review</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Upper Extremity - injuries</subject><subject>Upper Extremity - physiopathology</subject><subject>Upper Extremity - surgery</subject><issn>0009-921X</issn><issn>1528-1132</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkUtLAzEUhYMotlZ_gBsZcONmNI_JJNkopb4KguAD3YU0ubVT2pmazFT6781QFRUEV-HmnntObj6E9gk-JhiLk0CIUirFJE95rFO1gbqEU5kSwugm6mKMVaooee6gnRCmsWQZp9uoQ0WmaC5lF509TaBMBqZMhsm5L5aQ9Mc1-OTW15NqYcAVNrlv_Av41VnST-5XoYa5qePtHSwLeNtFW2MzC7D3cfbQ4-XFw-A6vbm9Gg76N6nlgtWpw8CFy2nMJ2ObM8md48TkynGejRwHKRyMaJYRkEwaB0ZYrqyV-YhyZy3rodO176IZzcFZKGtvZnrhi7nxK12ZQv_slMVEv1RLzbHkimXR4OjDwFevDYRaz4tgYTYzJVRN0EQywSilUv5HmimVk7hODx3-kk6rxpfxJ1pV9BNStNlkrbK-CsHD-OvdBOuWpF6T1JGkbklqFWcOvi_8NfGJLgroWhBiq4yAvkX_6foOAcmoCA</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>DiSilvestro, Kevin J.</creator><creator>Santoro, Adam J.</creator><creator>Tjoumakaris, Fotios P.</creator><creator>Levicoff, Eric A.</creator><creator>Freedman, Kevin B.</creator><general>Springer US</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20161201</creationdate><title>When Can I Drive After Orthopaedic Surgery? A Systematic Review</title><author>DiSilvestro, Kevin J. ; Santoro, Adam J. ; Tjoumakaris, Fotios P. ; Levicoff, Eric A. ; Freedman, Kevin B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c573t-d0e57d623451fc6385dd51a69d554bd5e87deb2441e838adea7c59cc86b25dcc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Accidents, Traffic - prevention & control</topic><topic>Automobile Driving</topic><topic>Biomechanical Phenomena</topic><topic>Conservative Orthopedics</topic><topic>Humans</topic><topic>Lower Extremity - injuries</topic><topic>Lower Extremity - physiopathology</topic><topic>Lower Extremity - surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedic Procedures - adverse effects</topic><topic>Orthopedics</topic><topic>Postoperative Complications - etiology</topic><topic>Range of Motion, Articular</topic><topic>Reaction Time</topic><topic>Recovery of Function</topic><topic>Risk Factors</topic><topic>Spine - physiopathology</topic><topic>Spine - surgery</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Systematic Review</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Upper Extremity - injuries</topic><topic>Upper Extremity - physiopathology</topic><topic>Upper Extremity - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DiSilvestro, Kevin J.</creatorcontrib><creatorcontrib>Santoro, Adam J.</creatorcontrib><creatorcontrib>Tjoumakaris, Fotios P.</creatorcontrib><creatorcontrib>Levicoff, Eric A.</creatorcontrib><creatorcontrib>Freedman, Kevin B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical orthopaedics and related research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DiSilvestro, Kevin J.</au><au>Santoro, Adam J.</au><au>Tjoumakaris, Fotios P.</au><au>Levicoff, Eric A.</au><au>Freedman, Kevin B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>When Can I Drive After Orthopaedic Surgery? A Systematic Review</atitle><jtitle>Clinical orthopaedics and related research</jtitle><stitle>Clin Orthop Relat Res</stitle><addtitle>Clin Orthop Relat Res</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>474</volume><issue>12</issue><spage>2557</spage><epage>2570</epage><pages>2557-2570</pages><issn>0009-921X</issn><eissn>1528-1132</eissn><abstract>Background
Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, to estimate when patients can safely resume driving after surgery, and patient survey data describing when patients report a return to driving, but they do not all agree. We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive.
Questions/purposes
Based on the available evidence, we sought to determine when patients can safely return to driving after (1) lower extremity orthopaedic surgery and injuries; (2) upper extremity orthopaedic surgery and injuries; and (3) spine surgery.
Methods
A search was performed using PubMed and EMBASE
®
, with a list of 20 common orthopaedic procedures and the words “driving” and “brake”. Selection criteria included any article that evaluated driver safety or time to driving after major orthopaedic surgery or immobilization using observer-reported outcome measures or survey data. A total of 446 articles were identified from the initial search, 48 of which met inclusion criteria; abstract-only publications and non-English-language articles were not included. The evidence base includes data for driving safety on foot, ankle, spine, and leg injuries, knee and shoulder arthroscopy, hip and knee arthroplasty, carpal tunnel surgery, and extremity immobilization. Thirty-four of the articles used observer-reported outcome measures such as total brake time, brake response time, driving simulator, and standardized driving track results, whereas the remaining 14 used survey data.
Results
Observer-reported outcome measures of total brake time, brake response time, and brake force postoperatively suggested patients reached presurgical norms 4 weeks after right-sided procedures such as TKA, THA, and ACL reconstruction and approximately 1 week after left-sided TKA and THA. The collected survey data suggest patients resumed driving 1 month after right-sided and left-sided TKAs. Patients who had THA reported returning to driving between 6 days and 3 months postoperatively. Observer-reported outcome measures showed that patients’ driving abilities often are impaired when wearing an immobilizing cast above or below the elbow or a shoulder sling on their dominant arm. Patients reported a return to driving on average 2 months after rotator cuff repair procedures and approximately 1–3 months postoperatively for total shoulder arthroplasties. Most patients with spine surgery had normal brake response times at the time of hospital discharge. Patients reported driving 6 weeks after total disc arthroplasty and anterior cervical discectomy and fusion procedures.
Conclusions
The available evidence provides a best-case scenario for when patients can return to driving. It is important for observer-reported outcome measures to have normalized before a patient can consider driving, but other factors such as strength, ROM, and use of opioid analgesics need to be considered. This review can provide a guideline for when physicians can begin to consider evaluating these other factors and discussing a return to driving with patients. Survey data suggest that patients are returning to driving before observer-reported outcome measures have normalized, indicating that physicians should tell patients to wait longer before driving. Further research is needed to correlate observer-reported outcome measures with adverse events, such as motor vehicle accidents, and clinical tests that can be performed in the office.
Level of Evidence
Level III, therapeutic study</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27492688</pmid><doi>10.1007/s11999-016-5007-9</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0009-921X |
| ispartof | Clinical orthopaedics and related research, 2016-12, Vol.474 (12), p.2557-2570 |
| issn | 0009-921X 1528-1132 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5085934 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Accidents, Traffic - prevention & control Automobile Driving Biomechanical Phenomena Conservative Orthopedics Humans Lower Extremity - injuries Lower Extremity - physiopathology Lower Extremity - surgery Medicine Medicine & Public Health Orthopedic Procedures - adverse effects Orthopedics Postoperative Complications - etiology Range of Motion, Articular Reaction Time Recovery of Function Risk Factors Spine - physiopathology Spine - surgery Sports Medicine Surgery Surgical Orthopedics Systematic Review Time Factors Treatment Outcome Upper Extremity - injuries Upper Extremity - physiopathology Upper Extremity - surgery |
| title | When Can I Drive After Orthopaedic Surgery? A Systematic Review |
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