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Driving after total knee replacement

6/7/2016

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Christopher Gorczynski discusses driving after total knee replacement surgery. When is it safe to drive after knee replacement surgery?
When can I drive?

This is a very common question patients ask following surgery. Some studies have suggested that reaction time and/or braking force is reduced for weeks or even months following total knee replacement surgery. This could lead us to recommend that patients do not drive for a prolonged period of time following total knee replacement surgery. Logistically, this can be challenging. 

​A recent study showed that patients with osteoarthritis of the knee (without having undergone knee replacement surgery) had reduced driving ability based on diminished reaction time, movement time, and they ultimately had reduced braking performance. In spite of these findings, is not reasonable to tell patients with osteoarthritis of the knee that they can never drive. 

A brand new article in the Journal of Arthroplasty shows that 80% of patients have regained their pre-surgery braking performance by 2 weeks following total knee replacement. All patients in this study were back to baseline by 4 weeks. 

This reinforces my standard recommendation, but still leaves out one key issue. Pain medication. Narcotic pain medication is commonly used for several weeks following total knee replacement. This can impair driving skill and reaction time independent of knee surgery.

My recommendation to patients after total knee replacement surgery is that they should not drive while they are using narcotic medications. Furthermore, they should not drive until they feel comfortable doing so. This time period is patient specific, and there is a wide range. Common sense should prevail.  I believe patients generally know themselves, and certainly do not want to place anyone at risk by driving prematurely. 

I recommend patients focus as much as possible on rehabilitating their new total knee replacement for the first few weeks, limiting their driving to the essentials:  food shopping, physical therapy, and follow-up with their orthopedic surgeon. Soon, their pain level will be down, and their confidence to drive will return.

We can then add driving to the list of lifestyle improvements made possible by total knee replacement. 

As always...please discuss specific recommendations with your surgeon. 

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