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

At a Glance

Key Highlights

• Among 306 analyzed patients, median time to driving resumption was 6 weeks after total hip or total knee arthroplasty and 4 weeks after medial unicompartmental knee arthroplasty.
• Median time to resumption was 4 weeks after left-sided surgery and 6 weeks after right-sided surgery.
• By 6 weeks, 77% of total hip arthroplasty, 65% of total knee arthroplasty, and 80% of medial unicompartmental knee arthroplasty patients had resumed driving.
• The study reported 2.8 times the odds of delayed driving resumption beyond 6 weeks among female versus male patients; interpret this association cautiously because subgroup analyses were uncertain.
• Two patients (0.7%) reported a postoperative automobile traffic incident; driving performance was not objectively assessed.

Guideline-Based Recommendations

Diagnosis

Management

• 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 researchers concluded that recommendations should be individualized based on a comprehensive assessment rather than relying solely on a fixed recovery interval.

Monitoring & Follow-up

• Assess functional recovery relevant to safely operating a vehicle before advising return to driving.

Risks

• The study did not objectively assess driving performance; the low number of reported traffic incidents does not establish the safety of earlier driving.
• Driving resumption was self-reported 3 to 12 months after discharge and may be affected by recall bias.

Patient & Prescribing Data

The analysis included 306 licensed drivers: 134 total hip arthroplasty, 103 total knee arthroplasty, and 69 medial unicompartmental knee arthroplasty patients.

Patients underwent primary unilateral arthroplasty in a fast-track program with mobilization on the day of surgery; at least 30% were discharged the same day. Driving resumption was self-reported.

Clinical Best Practices

• Study-reported patient advice was to resume driving only when able to operate a vehicle safely without functional impairment of the operated limb and when no longer under the influence of opioids.
• The researchers recommended individualized recommendations based on comprehensive assessment; the study did not establish a fixed safe recovery interval.
• Interpret reported return-to-driving times cautiously because driving performance was not objectively measured and subgroup analyses were uncertain.

Related Resources & Content

• Acta Orthopaedica study, as summarized in the supplied article