When Can I Drive After Orthopaedic Surgery? A Systematic Review

Area of Science:

• Orthopaedic Surgery and Rehabilitation
• Traffic Safety and Driver Performance

Background:

• Conflicting data exist on safe return-to-driving timelines post-orthopaedic surgery.
• Patient-reported driving return times often differ from objective driving performance measures.
• A systematic review is needed to consolidate evidence on driving safety after common orthopaedic procedures.

Purpose of the Study:

• To determine safe return-to-driving intervals after lower extremity orthopaedic surgery/injuries.
• To establish safe return-to-driving intervals after upper extremity orthopaedic surgery/injuries.
• To establish safe return-to-driving intervals after spine surgery.

Main Methods:

• Systematic literature search of PubMed and EMBASE for orthopaedic procedures and driving.
• Inclusion of studies using objective measures (e.g., brake time, simulators) or patient surveys.
• Analysis of 48 articles covering various orthopaedic surgeries and injuries.

Main Results:

• Objective measures indicate return to pre-surgical driving norms around 4 weeks post-right-sided procedures (e.g., TKA, THA, ACL reconstruction).
• Patient surveys report return to driving sooner, around 1 month for TKAs and 6 days to 3 months for THAs.
• Immobilization (casts, slings) significantly impairs driving ability; return-to-driving varies by procedure and side (e.g., 2 months for rotator cuff repair).

Conclusions:

• Objective driving performance should normalize before patients consider driving post-surgery.
• Physicians should advise patients to wait longer than self-reported return-to-driving times suggest.
• Further research is needed to correlate objective measures with real-world driving accident data.