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Getting Back on the Road: A Detailed Analysis
Many patients who undergo anterior hip replacement surgery are eager to get back behind the wheel as soon as possible. The question on everyone’s mind is: “When can I start driving again?” To shed some light on this important matter, we’ve compiled a comprehensive study that examines the driving habits and experiences of patients post-surgery.
Exploring the Results
Our study included 138 patients, and an astounding 76% of them were able to resume driving within the first three weeks following their surgery. Out of these individuals, 25% were able to get back on the road within the first week, while 39% regained their driving capabilities in the second week. Additionally, 23% of patients were back behind the wheel during the third week (Figure 1).
Interestingly, we found that 45 patients could have started driving sooner but opted for alternative transportation due to personal preferences. On the other end of the spectrum, there were 29 patients (13.7%) who did not resume driving within eight weeks post-surgery. One patient had medical comorbidities, while the remaining 28 relied on their families for transportation. However, these individuals expressed confidence in their ability to drive if necessary.
No Dominance: The Impact of Operative Side
When comparing the driving timelines of patients who underwent left-sided total hip arthroplasty (THA) versus right-sided THA, we discovered no significant difference in the time it took to resume driving (x2 = 3.37, p = 0.50). However, it is crucial to note that a staggering 90.66% of patients reported feeling more comfortable driving post-surgery due to the elimination of arthritic hip pain and stiffness. This newfound comfort translated into easy entry and exit from their vehicles.
Comfort and Adaptation
Of the patients surveyed, over 92% were able to climb stairs independently before resuming driving. The remaining individuals used side rails for support. Notably, 82% of patients drove automatic cars, while 6% preferred manual transmission. The remaining 12% did not provide an answer to this question. Interestingly, the transmission type of the vehicle did not correlate significantly with the time it took patients to start driving again (x2 = 0.013, p = 0.91).
Getting Back to Work
At the time of their hip replacement operation, 29.8% of patients were still working, while the rest were retired. Among the working patients, it took an average of 24 days for them to return to their regular work capacity, with the range being 1-79 days.
Mobility: An Essential Factor
Approximately half (49.5%) of our patients were already mobile without any walking aids before they resumed driving (Table 2). Of the remaining patients, 74% were using a single crutch. It is worth mentioning that all patients tested their car brakes before getting back on the road. While only 3.85% reported feeling unsure about their emergency braking skills in the six weeks following surgery, 16.5% mentioned experiencing mild pain while driving. However, this pain did not distract them or hamper their driving abilities. Additionally, 1% of patients felt slightly drowsy during their initial drive after surgery and decided to delay further driving for an extra week.
Safety and Patient Experience
Patients were provided with clear instructions to avoid narcotics before resuming driving, which helped ensure their safety. Notably, in our study group, there were no reports of dislocations, infections, thromboembolic events, motor vehicle accidents (MVA), or near misses during follow-up consultations or in the driving questionnaire.
Unveiling the Mechanics: Joint Movements and Driving
Our study also explored the impact of joint movements on driving. Analyses of angles of flexion at the hip, knee, and ankle during simulated acceleration and emergency braking indicated that ankle movements have the most significant influence. While accelerating, patients generally required ankle plantar flexion within a range of 0-43°. During braking, most patients had their ankle in a 0-10° plantar flexion (Figures 3 and 4).
When considering emergency braking, the ankle’s plantar flexion range may rise to 30° as drivers exert maximum force to compress the brake fully. Hip and knee movements required an average flexion of 71° (66°-76°) and 53° (38°-70°), respectively, in the simulated driving positions. Notably, when shifting their right lower extremity from the accelerator to the brake in automatic vehicles, patients exhibited hip adduction and internal rotation of up to 5-10°.
To visualize these findings, please refer to Figure 2.
Remember, if you’re considering anterior hip replacement surgery and have concerns about when you can safely drive again, consult with your healthcare provider for personalized advice based on your specific situation.
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