Return of TKA knee arthroplasty patients to driving a car. Comparative systematics

Abstract

Background. Despite the availability of numerous articles and analyses carried out in many healthcare centres, there is still no specific guidelines for both orthopaedic surgeons, and physical therapists for patients preparation after total knee arthroplasty to return to driving a car. The influence of many factors should be taken into account, such as: the operated side, the pain associated with the injury and surgery, the lack of sufficient force to slow down in extreme conditions, the patient’s reaction time and the lack of self-confidence when making such an important decision. Both the patient and the doctor who decides to let the patient drive a car must be aware that this is a very complex and responsible action. This may have an impact on the safety of the patient himself as well as other road users. The aim of the study was to analyse the research carried out so far and to help doctors and physiotherapists in taking the decision of returning the patient to driving a car. Most of the available studies are based on driving simulators and automatic gearboxes where a safe braking element is achieved in three to six weeks, where left-sided TKA patients can return to driving after 4 weeks. The most promising research seems to be in real driving, which allows them to return to driving just 3 weeks after the procedure. Material and metods. The medical databases, i.e. PubMed and Medline were searched for articles concerning the studied issue. The search have covered all databases until April 2020. Most of the work presented is based on a 1994 study and article made by Spalding, who was the first who conduct a study concerning the return of TKA patients to driving. Results and Conclusions. Safe, possible return to driving in patients after TKA is possible 6 weeks after the procedure.