Return to Driving After Hip and Knee Arthroscopic Procedures: A systematic review and meta-analysis

Palma, Samantha; Patel, Purva; Palan, Jeya; Pandit, HG; Van Duren, BH · 2020 · Crossref

DOI: 10.18060/24723

archive: archived pipeline: cataloged verified

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Summary

This systematic review and meta-analysis addresses the clinical uncertainty surrounding the safe timeline for patients to resume driving following hip and knee arthroscopic procedures. The study was motivated by the frequent patient inquiries regarding post-operative independence and the critical need for physicians to balance patient safety with the potential legal and physical risks posed to others on the road. By consolidating existing evidence, the authors aimed to establish data-driven recommendations for when brake reaction times (BRT) return to baseline levels, thereby defining a safe window for returning to driving. The researchers conducted the study adhering to PRISMA guidelines, searching OVID, EMBASE, and COCHRANE databases through June 2020. The search strategy utilized keywords and MeSH terms related to "hip arthroscopy" and "knee arthroscopy" combined with "total brake response time" or "reaction time" in the context of automobile driving. Following title and full-article reviews to assess quality and relevance, eight papers were selected for inclusion in the meta-analysis. Statistical analysis was performed using Review Manager Version 5.4 to evaluate changes in BRT relative to baseline control values. The meta-analysis revealed distinct recovery trajectories for hip and knee procedures. For knee arthroscopy, BRTs remained slower than or equal to baseline through five weeks post-surgery. A trend toward improvement emerged between weeks 6 and 10, with statistically significant improvements observed specifically at weeks 8 and 10 (P < 0.05). In contrast, hip arthroscopy patients exhibited slower-than-baseline BRTs at week 2. However, from week 4 onward, a trend toward faster BRTs was noted through week 8, with statistical significance achieved only at week 8 (P < 0.05). These findings indicate that while knee recovery is more prolonged, hip recovery allows for a quicker return to pre-operative reaction speeds. Based on these results, the authors conclude that BRTs meet baseline values and continue to improve after six weeks following knee arthroscopy and after four weeks following hip arthroscopy. Consequently, the study recommends that it is safe for patients to return to driving six weeks after knee arthroscopic procedures and four weeks after hip arthroscopic procedures. These specific timelines provide clinicians with evidence-based guidance to advise patients, ensuring that the return to driving does not compromise safety due to impaired reaction times.

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• post concussion