Driving After Joint Replacement Surgery: When is it Safe?
For many adults, driving a vehicle and feeling independent go hand-in-hand. After joint replacement surgery, driving represents freedom, progress, and a return to your new normal. In short, getting back into the driver's seat is a major and meaningful milestone. So, when is it safe to drive after a hip replacement or knee replacement?
A journal in Clinical Orthopedics and Related Research shares that, "Patients are often eager to return to driving, which allows them to resume their social and recreational activities or even to return to work".
"When can I drive after my joint replacement?" is one of the most frequently asked questions after joint surgery and a recurring, popular thread in our support group. To get to the bottom of driving safely after a replacement, we interviewed Dr. John Tiberi, MD OS (orthopedic surgeon) at Kerlan-Jobe Orthopaedic Clinic in Los Angeles.
When is it Safe to Start Drive After my Joint Replacement?
Dr. Tiberi starts off by saying that "I would encourage patients to discuss this question with their doctor". Every patient is different and there isn't one set, proven length of time before someone can drive after their replacement. Numerous factors go into determining when a patient can safely get behind the wheel again, so it's not a "one size fits all".
Dr. Tiberi illustrates, "Somebody who's younger, in good physical shape, has their left hip done and drives a automatic car is very different from another patient who is unfit and is recovering from their right knee replacement." In saying this, there are certainly indicators of which joint replacement patients may drive earliest.
Note: Before driving, consult your orthopedic surgeon and care team. They should sign-off on you operating a car after surgery.
What helps to determine when you'll drive after surgery:
Your overall physical fitness and health before surgery
If you've done physical therapy before and after surgery
Your vehicle's transmission (automatic or standard)
Surgical side (right, left, both)
Joint replacement type (THR, TKR, PKR, PKA, THA, TKA, BTKR, BTHR etc. Click here to learn the different acronyms associated with hip and knee replacement surgery.)
Whether you've had a traditional or minimally invasive procedure
The type of pain medication/ dose you are taking
If you've suffered from any post-op complications
Your car insurance! A lot of insurance companies require your physician/ surgeon to sign-off after surgery before your insurance is valid again.
Despite the belief that age and gender play a role in how quickly you return to driving, this is largely unproven. However, lifestyle factors, your surgery PreHab & ReHab, your surgery type, and surgical side (driving leg or not) all play a role. For example, if you're in good overall shape before surgery, had a left minimally-invasive hip replacement done, and are working through a ReHab program, you're likely to drive before someone who had a right traditional knee replacement, who is less physically healthy, and did not PreHab before surgery.
Dr. Tiberi zeroes in on two "make or break" criteria for when it's safe to drive again. Firstly, Dr. Tiberi states that patients under no circumstance should "drive on any narcotic pain medication". With many types of narcotic/ opioid pain medication, you should not be driving or operating heavy machinery. These medications will make you impaired, drowsy, and unable to operate a vehicle safely. Learn more about opioid pain medication after hip and knee replacement surgery.
According to Dr. Tiberi, the second critical criteria is being able to break quickly. If you don't think you're able to slam on your breaks or can't practice reacting quickly, you simply aren't ready to drive. Dr. Tiberi explains that knowing when you can react quickly enough is "largely based on how the patient feels but also with what the medical team has to say." Read on as we look more into breaking times and finally, when exactly you can expect to drive again.
When Can I Expect to Drive Again? How Many Weeks?
A benchmark estimate you've probably seen online or read in your hospital's pamphlet is that you're likely to drive again between 6-8 weeks (especially if you've had a right-sided knee replacement). Although it can be helpful to have a number in mind, not all patients will drive at the 6-8 week mark, and some patients will drive before. Older studies, like the 2003 study "Brake Response Time After Total Knee Arthroplasty", suggested that 6 weeks was the minimum before operating a vehicle for most knee replacements.
Newer studies have found that due to "recent advances in surgical technique, pain management, and rehabilitation" right-sided total knee replacement (RTKR) patients may be ready to safely drive as early as 4 weeks post-op. This study looked at 29 patients having right TKA (total knee arthroplasty or total knee replacements) and measured the groups preoperative breaking and reaction times compared to post-op reaction times. The study found that "all 29 patients passed the brake response test by 4 weeks after surgery." In addition, the study found that by 4 weeks after surgery, reaction times for breaking had surpassed the patient's preoperative reaction times.
According to the study, "Patients who had a contemporary TKA with less tissue disruption, a multimodal pain management protocol, and aggressive rehabilitation returned to their preoperative braking reaction time by 4 weeks after surgery."
Could this mean that patients facing contemporary a right-sided total knee replacement (who historically would have the longest recovery before driving again) may actually have improved or comparable pre-op breaking times as early as 4 weeks? Well, again, a lot of factors go into determining who will drive earliest but this study does speak to how far joint replacement surgery has progressed and how much recovery times have sped up.
In sum, patients that tend to drive the fastest:
1. Had minimally-invasive surgery. The less muscle and tissue damage, the faster healing can be. Therefore having a minimally-invasive (contemporary) replacement with a shorter incision may lead to a quicker recovery. With this, a knee replacement tends to take longer to heal than a hip replacement (especially in the context of driving).
2. Had a left-sided replacement. If you've had a hip or knee replacement on your left side, your breaking times are less affected. Since you break and accelerate with your right side, having a right knee or hip replacement can mean slower reaction times in an emergency situation.
3. Practice multimodal pain management. It isn't safe to drive while you're on narcotic pain medication after surgery. By employing drug-free pain management techniques like mindfulness meditation, natural medication (like CBD) or over-the-counter medication like acetaminophen, you may require a lower dose of narcotic pain medication for less time.
What is multimodal pain management? Find out what exactly it is and how it can reduce your opioid use for pain management.
4. You Did PreHab and ReHab. PreHab makes your muscles and supporting ligaments stronger before surgery. This means that you're working towards your physical recovery before you've even had surgery. An at-home ReHab program paired with physical therapy means you're actively improving range of motion, flexibility, strength, response times etc. in those important weeks after surgery.
Are you facing a hip or knee replacement surgery? Perhaps another orthopedic surgery? We happen to specialize in getting folks ready for their orthopedic procedures to lower surgery day risk, speed up recovery, and offer unconditional support. Learn more about PeerWell's PreHab and ReHab.