Brake response time is significantly impaired after total knee arthroplasty: investigation of performing an emergency stop while driving a car

Am J Phys Med Rehabil. 2015 Sep;94(9):665-76. doi: 10.1097/PHM.0000000000000342.

Abstract

Objective: The objective of this study was to investigate whether total knee arthroplasty (TKA) impairs the ability to perform an emergency stop.

Design: An automatic transmission brake simulator was developed to evaluate total brake response time. A prospective repeated-measures design was used. Forty patients (20 left/20 right) were measured 8 days and 6, 12, and 52 wks after surgery.

Results: Eight days postoperative total brake response time increased significantly by 30% in right TKA and insignificantly by 2% in left TKA. Brake force significantly decreased by 35% in right TKA and by 25% in left TKA during this period. Baseline values were reached at week 12 in right TKA; the impairment of outcome measures, however, was no longer significant at week 6 compared with preoperative values. Total brake response time and brake force in left TKA fell below baseline values at weeks 6 and 12. Brake force in left TKA was the only outcome measure significantly impaired 8 days postoperatively.

Conclusion: This study highlights that categorical statements cannot be provided. This study's findings on automatic transmission driving suggest that right TKA patients may resume driving 6 wks postoperatively. Fitness to drive in left TKA is not fully recovered 8 days postoperatively. If testing is not available, patients should refrain from driving until they return from rehabilitation.

MeSH terms

  • Accidents, Traffic / prevention & control
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / methods
  • Arthroplasty, Replacement, Knee / rehabilitation*
  • Automobile Driving*
  • Emergencies
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / rehabilitation
  • Osteoarthritis, Knee / surgery*
  • Patient Safety
  • Postoperative Period
  • Prospective Studies
  • Reaction Time / physiology*
  • Reflex, Startle / physiology
  • Risk Assessment
  • Sampling Studies
  • Task Performance and Analysis
  • Time Factors