Clinical Report: Left- vs right-sided arthroplasty: Who drives sooner?

Overview

In a prospective cohort of 306 licensed patients in a fast-track arthroplasty program, most resumed driving within six weeks. Median return was four weeks after medial unicompartmental knee arthroplasty (mUKA) or left-sided surgery, compared with six weeks after total hip arthroplasty (THA), total knee arthroplasty (TKA), or right-sided surgery. Female sex was associated with higher odds of resuming driving after six weeks; driving performance was not objectively assessed.

Background

Driving resumption after hip and knee arthroplasty involves recovery of function and the ability to operate a vehicle without impairment. In the study, patients were advised to resume driving only when they could safely operate a vehicle without functional impairment of the operated limb and were no longer under the influence of opioids. The supplied clinical guidance describes readiness as individualized rather than tied to a fixed postoperative interval. The study authors note that driving is a complex skill and recommend individualized assessment.

Data Highlights

Key Findings

• This single-center prospective cohort included patients undergoing primary unilateral THA, TKA, or mUKA in a fast-track program at Odense University Hospital from September 2022 to July 2023.
• Among 306 licensed patients analyzed, median time to driving resumption was 4 weeks after mUKA and 6 weeks after THA or TKA.
• Driving resumption was earlier after left-sided than right-sided surgery: 22% versus 8% had resumed within 2 weeks, and median time was 4 versus 6 weeks.
• Female patients had 2.8 times the odds of delayed driving resumption beyond 6 weeks compared with male patients. Age, arthroplasty type, surgical side, frailty, preoperative psychiatric medication use, and preoperative opioid use were not statistically significantly associated with delay in the adjusted analysis.
• Two patients (0.7%) reported a postoperative traffic incident; the authors cautioned that the low number of incidents and absence of objective driving assessment do not establish the safety of earlier driving.
• The supplied AAOS guidance states that driving is generally safe when opioid pain medication has stopped and strength and reflexes have returned toward normal; it does not specify a fixed timeline.

Clinical Implications

The study's advice was to resume driving only when patients could safely operate a vehicle without functional impairment of the operated limb and were no longer under the influence of opioids. Its findings describe self-reported timing, not objectively measured driving readiness or safety, so they do not establish a universally safe postoperative interval.

Conclusion

In this fast-track cohort, driving resumption commonly occurred within six weeks, with earlier median return after mUKA and left-sided surgery. The authors emphasized individualized recommendations, while noting that objective driving performance was not assessed.

Related Resources & Content

1. Danielsen et al., Acta Orthopaedica, 2026 -- When do patients resume driving after fast-track hip and knee arthroplasty: a cohort study of 408 patients
2. American Academy of Orthopaedic Surgeons (AAOS), OrthoInfo, n.d. -- Activities After Total Knee Replacement
3. Rehabilitation and Pain Management Following Total Hip Arthroplasty: Insights from a Multisurgeon, Single-Center Prospective Cohort Analysis
4. Improved Early Outcomes with Enhanced Recovery Protocols in Total Hip Arthroplasty Compared to Traditional Methods in a Randomized Clinical Trial
5. No significant differences in postoperative discomfort and adverse effects between traditional and enhanced recovery approaches for total hip arthroplasty with early mobilization
6. Knee Surgery, Sports Traumatology, Arthroscopy — Enhanced mediolateral load distribution with no negative laxity effects in robot-assisted knee arthroplasty versus traditional manual measured resection methods
7. When do patients resume driving after fast-track hip and knee arthroplasty: a cohort study of 408 patients
8. Activities After Total Knee Replacement - OrthoInfo - AAOS