Bäcker Henrik C, Krüger David, Spies Sophie, Perka Carsten, Kirschbaum Stephanie M, Hardt Sebastian
Center for Musculoskeletal Surgery, Charité Berlin, University Hospital Berlin, Berlin, Germany.
Hip Int. 2022 Jan;32(1):51-55. doi: 10.1177/1120700020936635. Epub 2020 Jun 23.
The correct moment for return to driving after total hip arthroplasty (THA) remains unclear. Until today no uniform recommendation exists on the ability to perform an emergency brake.The aim of this prospective study was to investigate the braking ability of patients before and after THA implantation based on brake reaction time in milliseconds (BRT) and braking force in N (BF).
In total, 25 patients (15 men, 10 women, mean age 51.3 ± 10.1 years) were treated with THA on the right side. Inclusion criteria consisted of a valid driving licence, frequent road participation and at least 2 years of driving experience. Exclusion criteria were underlying neurological disorders as well as severe complaints in the lumbar spine and the right knee joint. The brake ability was evaluated for emergency braking with a car simulator and a measuring sole. Measurements were performed preoperatively, 6 days, 2, 4 and 6 weeks after surgery.
Preoperatively, the mean BRT was 671.3 ± 123.5 ms and the BF 455.4 ± 185.0 N. Significant differences were observed at 6 days and 2 weeks after surgery, (BRT 836.4 ± 219.7 ms, respectively, BRT 735.0 ± 186.7 ms, and BF 302.6 ± 154.9 N, respectively, BF 375.5 ± 149.3 N, < 0.05). Only 4 weeks after, no significant differences were seen compared to pre-operative with a BRT of 647.0 ± 91.9ms ( = 0.354) and BF of 435.9 ± 177.4 ( = 0.843). Furthermore, the BRT improved significantly after 6 weeks (607.4 ± 87.6; = 0.005).
The braking force is significantly reduced, and the brake reaction time is prolonged directly after surgery for at least 2 weeks. After 4 weeks, no statistically significant differences were measured, although special care should still be taken during return to activity.
全髋关节置换术（THA）后恢复驾驶的正确时机仍不明确。迄今为止，对于紧急制动能力尚无统一建议。这项前瞻性研究的目的是基于以毫秒为单位的制动反应时间（BRT）和以牛顿为单位的制动力（BF），调查THA植入前后患者的制动能力。
共有25例患者（15名男性，10名女性，平均年龄51.3±10.1岁）接受了右侧THA治疗。纳入标准包括有效的驾驶执照、频繁参与道路活动以及至少2年的驾驶经验。排除标准为潜在的神经系统疾病以及腰椎和右膝关节的严重不适。使用汽车模拟器和测量鞋垫对紧急制动的制动能力进行评估。在术前、术后6天、2周、4周和6周进行测量。
术前，平均BRT为671.3±123.5毫秒，BF为455.4±185.0牛顿。在术后6天和2周观察到显著差异（BRT分别为836.4±219.7毫秒，BRT为735.0±186.7毫秒，BF分别为302.6±154.9牛顿，BF为375.5±149.3牛顿，P<0.05）。仅在4周后，与术前相比未见显著差异，BRT为647.0±91.9毫秒（P=0.354），BF为435.9±177.4（P=0.843）。此外，6周后BRT显著改善（607.4±87.6；P=0.005）。
术后至少2周内，制动力显著降低，制动反应时间延长。4周后，虽无统计学显著差异，但恢复活动期间仍应特别小心。
