Purpose: This prospective cohort study aimed to examine objective and subjective parameters in patients who underwent total knee replacement (TKR) to assess from when on driving a car can be deemed safe again.
Methods: Thirty patients (16 women, 14 men, age 66±11 years) who received TKR of the right knee and 45 healthy controls (26 women, 19 men, age 32±9 years) were asked to perform an emergency braking manoeuvre using a driving simulator. Brake pedal force (BPF), neuronal reaction time (NRT), brake reaction time (BRT), and subjective parameters (pain, subjective driving ability) were measured preoperatively as well as 5 days, 3–4, and 6 weeks after TKR.
Results: Preoperative NRT was 506±162 ms, BRT 985±356 ms, and BPF 614±292 N. NRT increased to 561±218 ms, BRT to 1091±404 ms and BPF decreased to 411±191 N 5 days after TKR. Three weeks after surgery, NRT was 581±164 ms and BRT 1013±260 ms, while BPF increased to 555±200 N. Only BPF showed signifcant diferences (p<0.01). In week 6, all parameters were restored to baseline levels; patients showed signifcant pain decrease and evaluated their driving abil ity as “good” again.
Conclusion: BPF was the only parameter displaying a signifcant postoperative decrease. However, preoperative patients’ baseline levels and subjective confdence in driving ability were only reached 6 weeks after the operation. These results indicate that a minimum waiting period of 6 weeks should be considered before patients can safely participate in road traffic at their individual preoperative safety level again.
Level of evidence II.
