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When is it Safe to Drive After Total Ankle Arthroplasty?
Elizabeth L McDonald1,2, David I Pedowitz1, Rachel J Shakked1
1E. L. McDonald, D. I. Pedowitz, R. J. Shakked, D. J. Fuchs. B. S. Winters, J. N. Daniel, S. M. Raikin, Rothman Institute of Orthopaedics, Philadelphia, PA, USA.
Clinical Orthopaedics and Related Research
|August 20, 2019
Summary
Most patients can safely drive six weeks after total ankle arthroplasty (TAA). Delayed return to driving after TAA is associated with increased pain and ankle stiffness.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Rehabilitation Medicine
Background:
- Total ankle arthroplasty (TAA) is increasingly common, necessitating guidelines for return-to-driving criteria.
- The ankle's sagittal motion is crucial for effective braking, impacting driving safety post-surgery.
Purpose of the Study:
- To determine if brake-reaction time returns to safe levels within six weeks of TAA.
- To identify factors associated with delayed return of brake-reaction time after TAA.
Main Methods:
- Prospective study of 60 patients undergoing TAA, with brake-reaction time assessed postoperatively.
- A control group established safe brake-reaction time benchmarks (0.850 seconds).
- Patient-reported outcomes (pain, driver-readiness survey) and physical measures (ankle range of motion) were analyzed.
Main Results:
- 92% of patients achieved safe brake-reaction time by six weeks post-TAA.
- Patients with delayed return exhibited significantly higher pain scores and reduced ankle plantarflexion.
- All patients achieved safe brake-reaction time by nine weeks post-TAA.
Conclusions:
- The majority of patients can resume driving six weeks after TAA.
- Persistent pain and ankle stiffness are indicators for potentially delaying driving beyond six weeks.
- A three-week extension (to nine weeks) allows all patients to achieve safe brake-reaction times.
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