Influence of Left- and Right-Side Total Hip Arthroplasty on the Ability to Perform an Emergency Stop While Driving a Car

ObjectiveTo show the possible effect of left- and right-side total hip arthroplasty (THA) on the ability to perform an emergency stop when driving a car.DesignInception cohort.SettingA driving simulator using an actual car cabin, specifically developed for the experiment, was used for testing driving ability.ParticipantsPatients (N=40; 20 left-side THA/20 right-side THA) were tested preoperatively and in increments of 8 days and 6, 12, and 52 weeks after surgery.InterventionsLeft- and right-side THA.Main Outcome MeasuresReaction time, movement time, total brake response time (TBRT), and maximum brake force.ResultsEight days postoperatively, measurements on driving performance indicated a slight worsening for all outcome parameters in patients after left-side THA and considerably more worsening in patients after right-side THA. For both patient groups, significant improvements in outcome measures were noted during the 1-year follow-up. Brake force declined significantly in patients with left-side THA (P=.012) and in patients after right-side THA (P<.001). A total of 35% of the patients with right-side THA and 15% with left-side THA could not meet the 600ms TBRT threshold 6 weeks postoperatively.ConclusionsMost patients who underwent right-side THA reached their preoperative baseline 6 weeks after surgery. Most of the patients with left-side THA showed no TBRT limitations 8 days postoperatively. Because of the patients' highly individual rehabilitation course and considering the possible consequences of the premature resumption of driving a motor vehicle, individual examination and recommendation are necessary.