Schwienbacher Stefan, Aghayev Emin, Hofmann Ulf Krister, Jordan Maurice, Marmotti Antongiulio, Röder Christoph, Ipach Ingmar
Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Bern, Freiburgstrasse 4, 3010, Bern, Switzerland,
Int Orthop. 2015 Jul;39(7):1335-41. doi: 10.1007/s00264-015-2789-4. Epub 2015 May 7.
To assess whether reaction time (RT) and movement time (MT), as the two components of the total brake response time (TBRT) and brake force (BF) are different in patients with a foot joint arthrodesis in comparison to controls.
The study was a comparative case series in a driving simulator under realistic driving conditions. Mobile patients without a walker, ≥6 months after surgery who were driving a car and had no neurological co-morbidity, knee or hip joint prosthesis were included in the study. The selection criteria resulted in 12 patients with right tibiotalar joint arthrodesis (TTJA) and 12 patients with another right foot joint arthrodesis (OFJA), who were compared to 17 individuals without any ankle-joint pathology. For TBRT, an empirical safe driving threshold of 700 ms was used. The outcome measures were RT, MT, TBRT, BF and McGuire score.
MT (p = 0.034) and TBRT (p = 0.026) were longer in TTJA patients in comparison with the controls. Also, more patients with TTJA than patients with OFJA and controls exceeded the safe driving threshold (p = 0.028). The outcomes in OFJA patients and in controls were comparable. The McGuire score was similar between the TTJA and OFJA patients (p = 0.26).
Significantly slower MT and TBRT, and significantly more patients exceeding the safe driving threshold, were observed after a tibiotalar-joint arthrodesis in comparison to the controls. Patients with OFJAs were not significantly different from the controls. Driving and emergency braking may be impaired after tibiotalar-joint arthrodesis.
评估与对照组相比，足部关节融合术患者的反应时间（RT）和运动时间（MT）（作为总制动反应时间（TBRT）的两个组成部分）以及制动力（BF）是否存在差异。
本研究是在真实驾驶条件下于驾驶模拟器中进行的比较性病例系列研究。纳入研究的患者为术后≥6个月、无需助行器、能驾驶汽车且无神经合并症、膝关节或髋关节假体的可移动患者。根据选择标准，纳入了12例右胫距关节融合术（TTJA）患者和12例右足其他关节融合术（OFJA）患者，并与17例无踝关节病变的个体进行比较。对于TBRT，采用700毫秒的经验性安全驾驶阈值。观察指标包括RT、MT、TBRT、BF和麦圭尔评分。
与对照组相比，TTJA患者的MT（p = 0.034）和TBRT（p = 0.026）更长。此外，超过安全驾驶阈值的TTJA患者比OFJA患者和对照组更多（p = 0.028）。OFJA患者和对照组的结果具有可比性。TTJA患者和OFJA患者的麦圭尔评分相似（p = 0.26）。
与对照组相比，胫距关节融合术后观察到MT和TBRT明显更慢，且超过安全驾驶阈值的患者明显更多。OFJA患者与对照组无显著差异。胫距关节融合术后驾驶和紧急制动可能受损。
