Return-to-Driving Recommendations After Lower-Extremity Orthopaedic Procedures.

Area of Science:

• Orthopaedic Surgery
• Automotive Medicine
• Patient Safety

Background:

• Determining safe return-to-driving (RTD) timelines post-lower-extremity orthopaedic surgery is complex.
• Existing guidelines often lack specificity, and patient factors significantly influence RTD.
• Variations in state laws create ambiguity for surgeons regarding legal responsibilities.

Purpose of the Study:

• To outline recommended return-to-driving timelines for common lower-extremity orthopaedic procedures.
• To highlight key individual factors influencing safe return to driving.
• To underscore the importance of considering surgeon liability and state regulations.

Main Methods:

• Review of established return-to-driving recommendations for specific orthopaedic procedures.
• Identification of critical patient-specific variables impacting driving ability.
• Analysis of the legal landscape surrounding surgeon recommendations for driving.

Main Results:

• Specific RTD timelines were provided for various procedures, including ankle fracture (6-12 weeks), total ankle arthroplasty (6-9 weeks), Achilles tendon repair (6-7 weeks), total knee arthroplasty (1-4 weeks), and total hip arthroplasty (1-4 weeks).
• Factors such as injury severity, limb laterality, driving habits, vehicle transmission, and comorbidities are crucial considerations.
• Significant variability exists in state laws regarding surgeon responsibilities for RTD recommendations.

Conclusions:

• Return-to-driving timelines post-lower-extremity surgery are procedure-dependent but highly individualized.
• Comprehensive patient assessment, including functional status and comorbidities, is essential for safe RTD.
• Surgeons must navigate complex and often vague state laws when providing driving recommendations to mitigate liability.