Patients Generally May Return to Driving 4 Weeks After Hip Arthroscopy and 6 Weeks After Knee Arthroscopy: A Systematic Review and Meta-analysis

Samantha Palma; Vasileios Giannoudis; Purva Patel; Jeya Palan; Stephen Guy; Hemant Pandit; Bernard Van Duren

doi:10.1016/j.asmr.2021.08.015

Patients Generally May Return to Driving 4 Weeks After Hip Arthroscopy and 6 Weeks After Knee Arthroscopy: A Systematic Review and Meta-analysis

Arthrosc Sports Med Rehabil. 2021 Oct 6;3(6):e2067-e2092. doi: 10.1016/j.asmr.2021.08.015. eCollection 2021 Dec.

Authors

Samantha Palma¹, Vasileios Giannoudis², Purva Patel¹, Jeya Palan³, Stephen Guy⁴, Hemant Pandit³, Bernard Van Duren³

Affiliations

¹ Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
² Leeds Orthopaedic & Trauma Sciences, School of Medicine, University of Leeds, Leeds, England.
³ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, England.
⁴ Bradford Royal Infirmary, Bradford, England.

Abstract

Purpose: To consolidate the evidence from the available literature and undertake a meta-analysis to provide a reference for physicians to make evidence-based recommendations to their patients regarding the return to driving after hip or knee arthroscopic procedures.

Methods: A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The OVID, Embase, and Cochrane databases were searched through June 2020 for articles containing keywords and/or MeSH (Medical Subject Headings) terms "hip arthroscopy" and "knee arthroscopy" in conjunction with "total brake response time" or "reaction time" in the context of automobile driving. A title review and full article review were performed to assess quality and select relevant articles. A meta-analysis of qualifying articles was undertaken.

Results: Eight studies met the inclusion criteria for meta-analysis of brake reaction time (BRT). Meta-analysis of all knee BRTs showed times slower than or equal to baseline BRTs through 5 weeks, with a trend of improving BRTs from 6 to 10 weeks (weeks 8 and 10 were significant, P < .05). Among all hip BRTs, week 2 showed times slower than baseline BRTs, but after week 4, a trend toward faster BRTs was observed through week 8 (week 8 was significant, P < .05).

Conclusions: BRTs met baseline or control values and continued to improve after 6 weeks after knee arthroscopy and after 4 weeks after hip arthroscopy. On the basis of these results, it would be safe to recommend a return to driving at 6 weeks after knee arthroscopic procedures and 4 weeks after hip arthroscopic procedures.

Clinical relevance: These results can be used by surgeons to base their recommendations on to provide guidance for their patients on the resumption of driving. Although BRT is an important aspect of driving ability, there are additional factors that need to be taken into consideration when making these recommendations, including cessation of opioid analgesics, strength of the surgical limb, and range of motion.

Publication types

Review