The objective of this study was to investigate whether total knee arthroplasty (TKA) impairs the ability to perform an emergency stop.
An automatic transmission brake simulator was developed to evaluate total brake response time. A prospective repeated-measures design was used. Forty patients (20 left/20 right) were measured 8 days and 6, 12, and 52 wks after surgery.
Eight days postoperative total brake response time increased significantly by 30% in right TKA and insignificantly by 2% in left TKA. Brake force significantly decreased by 35% in right TKA and by 25% in left TKA during this period. Baseline values were reached at week 12 in right TKA; the impairment of outcome measures, however, was no longer significant at week 6 compared with preoperative values. Total brake response time and brake force in left TKA fell below baseline values at weeks 6 and 12. Brake force in left TKA was the only outcome measure significantly impaired 8 days postoperatively.
This study highlights that categorical statements cannot be provided. This study’s findings on automatic transmission driving suggest that right TKA patients may resume driving 6 wks postoperatively. Fitness to drive in left TKA is not fully recovered 8 days postoperatively. If testing is not available, patients should refrain from driving until they return from rehabilitation.
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME
After completion of this article, readers should be able to: (1) List important parameters of driving ability; (2) Describe the effect of TKA on driving parameters; (3) Formulate an individualized treatment plan; and (4) To return patients to safe driving after TKA.
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From the Department of Orthopaedic Surgery, University Hospital of Tübingen, Tübingen, Germany (MJ, U-KH, MG, TK); Institute for Medical Statistics and Epidemiology, University Hospital of the Technical University of Munich, Munich, Germany (IR); and Department of Orthopedic Surgery, Hospital of Ingolstadt, Ingolstadt, Germany (II).
All correspondence and requests for reprints should be addressed to: Maurice Jordan, MD, Department of Orthopaedic Surgery, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen D-72076, Germany.
The authors did not receive any grants or funds. There was no financial benefit for the authors. The results of this study have not been previously presented or published.
Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.