Lazar Tiberiu-Adrian, Edelmann Martin, Awiszus Friedemann, Lohmann Christoph H
Department of Orthopedic Rehabilitation, Celenus Fachklinik Teufelsbad, 18 Michaelstein Strasse, 38889, Blankenburg, Germany.
Department of Orthopedic Surgery, Otto-von-Guericke University, 44 Leipziger Strasse, 39120, Magdeburg, Germany.
Arch Physiother. 2021 Jun 29;11(1):16. doi: 10.1186/s40945-021-00111-4.
For a large proportion of the population, especially those residing in the countryside, the use of a car for daily activities is indispensable. Following a TKA or THA procedure, the overseeing physician will usually recommend refraining from driving, sometimes up to 12 weeks after surgery with a major social and economical impact on patient's life.
Considering the legal stipulations in Germany regarding fitness to drive a motor vehicle, the aim of this study is to determine the time point when patients after total knee arthroplasty (TKA) or total hip arthroplasty (THA) take up driving again postoperatively. Further, we assessed the replaced joint, side, gender, place of residence and physician's recommendations influencing the patient in making the decision to start driving again.
92 eligible participants, contained within the frame of a prospective experimental observational study, were contacted via telephone 12 weeks after surgery and interviewed using a structured questionnaire. The answers were statistically analysed using SPSS® Version 26 for Windows.
Male participants resumed driving between the 6th and 7th week post-surgery, female participants resumed driving between the 8th and 9th week post-surgery. For 58.6% of patients the reason for the first post-operative use of a vehicle was medical: the journey to physical therapy or to a doctor's appointment. There were statistically significant differences regarding operated side, gender and place of residence. TKA impaired patients the most. Patients recovering from a TKA drove considerably later. Patients recovering from a right sided TKA had an increased risk (9 times) not to become an "early driver". Female patients who underwent TKA had an increased risk by a factor of 21 of becoming a "late driver". In the ageing population, surgeons, physical therapists and rehabilitation professionals need to consider new approaches in providing options for patients' mobility. Interestingly, there is a different need for early use of own vehicle in rural regions whereas in cities patients start driving later. There are clear differences between gender and surgical site.
The rehabilitation following a right sided TKA proved a challenge with regard to the reuptake of driving. This should be taken into account when planning the course of therapy for patients who are driving regulary. Female patients could benefit from special training.
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对于很大一部分人口，尤其是居住在农村的人来说，使用汽车进行日常活动是必不可少的。在进行全膝关节置换术（TKA）或全髋关节置换术（THA）后，监督医生通常会建议患者避免开车，有时长达术后12周，这会对患者的生活产生重大的社会和经济影响。
考虑到德国关于驾驶机动车适宜性的法律规定，本研究的目的是确定全膝关节置换术（TKA）或全髋关节置换术（THA）患者术后再次开始开车的时间点。此外，我们评估了置换关节、手术侧、性别、居住地点以及影响患者做出再次开车决定的医生建议。
在一项前瞻性实验观察性研究框架内的92名符合条件的参与者在术后12周通过电话联系，并使用结构化问卷进行访谈。使用适用于Windows的SPSS® 26版本对答案进行统计分析。
男性参与者在术后第6至7周恢复开车，女性参与者在术后第8至9周恢复开车。对于58.6%的患者来说，术后首次使用车辆的原因是医疗方面的：前往物理治疗或看医生。在手术侧、性别和居住地点方面存在统计学上的显著差异。TKA对患者的影响最大。接受TKA手术康复的患者开车时间要晚得多。从右侧TKA手术康复的患者成为“早期驾驶者”的风险增加（9倍）。接受TKA手术的女性患者成为“晚期驾驶者”的风险增加21倍。在老龄化人群中，外科医生、物理治疗师和康复专业人员需要考虑为患者提供行动选择的新方法。有趣的是，农村地区对尽早使用自己车辆有不同需求，而城市患者开始开车的时间较晚。性别和手术部位之间存在明显差异。
事实证明，右侧TKA术后的康复在恢复驾驶方面是一项挑战。在为经常开车的患者规划治疗方案时应考虑到这一点。女性患者可能会从特殊培训中受益。
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