When can I drive after my joint replacement? By Devin Conway and Lee E. Rubin

When can I drive after my total joint replacement” is one of the most common questions that patients ask their surgeons when undergoing a partial or total hip or knee replacement. Historically, many surgeons suggested that patients wait at least six (6) weeks before resuming driving, especially when the joint replacement was performed on the right leg.Presently, we know that return to driving can safely be achieved much sooner. This largely depends on two factors:

• First, your ability to safely use the legs to operate the vehicle, which is referred to as “Brake Reaction Time” for the right foot (defined specifically as moving the foot from the gas to brake pedal in a timely fashion).
• Second, the overall ability to drive and control the vehicle without distraction. For example, patients who have a lot of pain or are still taking narcotic medication should not drive a vehicle.

There has been research done to look at brake reaction time after a total hip or knee replacement. After a total hip or knee replacement on the right leg, patients’ brake time usually returns to normal sometime between 2 and 4 weeks. Most patients are back to their baseline response time by 4 weeks, though occasionally it can take up to 6 weeks. After surgery on the left leg, the brake time is often back to normal (using the right foot) between 8 to 10 days (assuming an automatic transmission, not a stick/manual shift).

Bottom Line: Everyone heals differently, and most surgeons do not use a driving simulator or testing device to objectively assess a patient’s readiness to resume driving after joint replacement surgery. Thus, guidance from scientific research helps to best define the return to driving guidance we provide to our patients. In general, patients can drive when they can safely enter and exit the vehicle, control the vehicle, and are not taking any narcotic (opioid) pain medication.

• For Automatic Transmission Vehicles: Patients can expect to start driving again sometime between 2 and 4 weeks after a joint replacement on the right leg, and in just 1 to 2 weeks after a joint replacement on the left leg.
• For Manual Transmission Vehicles: Patients will require appropriate use of both feet and can expect between 4 and 6 weeks regardless of which leg had surgery.
• Once patients begin driving, they assume legal responsibility for controlling their own vehicle. This was discussed recently in an excellent New York Times article, linked as follows. “When is it safe to drive after breaking a bone?” Jan Hoffman, Well Blog, 12/3/2013: https://well.blogs.nytimes.com/2013/12/03/when-is-it-safe-to-drive-after-breaking-a-bone/?login=email&auth=login-email

References:

1. Backer HC et al. Effect of total hip arthroplasty on brake reaction time and braking force. Hip Int. 2020 Jun 23. doi: 10.1177/1120700020936635.
2. Davis JA, Bohl DD, and Gerlinger TL. Brake response time after modern total knee arthroplasty: How soon can patients drive? Knee. 2018 Oct;25(5):939-945.
3. Hartman J et al. Braking Time Following Total Knee Arthroplasty: A Systematic Review. JArthroplasty. 2018 Jan;33(1):284-290.
4. Jordan M et al. Influence of left- and right-side total hip arthroplasty on the ability to perform an emergency stop while driving a car. Arch Phys Med Rehabil. 2014 Sep;95(9):1702-1709.
5. Marques CJ et al. Does the brake response time of the right leg change after left total knee arthroplasty? A prospective study. Knee. 2008 Aug;15(4):295-298.
6. van der Velden CA et al. When is it safe to resume driving after total hip and total knee arthroplasty? A meta-analysis of literature on post-operative brake reaction times. Bone Joint J. 2017 May;99-B(5):566-576.