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下肢关节置换术后恢复驾驶的预测因素。

Predictive Factors for Return to Driving After Lower Limb Arthroplasty.

作者信息

Giannoudis Vasileios, Lee Katie, Shuweihdi Farag, Manktelow Andrew, Bloch Benjamin, van Duren Bernard, Pandit Hemant

机构信息

Leeds Orthopaedic & Trauma Sciences, School of Medicine, University of Leeds, Leeds, UK.

Nottingham Elective Orthopaedic Service, Nottingham University Hospitals NHS Trust, Nottingham, UK.

出版信息

Arthroplast Today. 2025 Apr 15;33:101685. doi: 10.1016/j.artd.2025.101685. eCollection 2025 Jun.

Abstract

BACKGROUND

A common question post total hip arthroplasty (THA)/total knee arthroplasty (TKA) arthroplasty is "Doctor, when can I drive?". No objective assessment currently exists. This study aimed to identify clinical factors predicting driving return post hip THA and TKA.

METHODS

In this single-center retrospective observational study, patients were reviewed at 6 weeks post THA and TKA. Patient demographics, driving status, timed up and go (TUG) test, self-reported walking time (SRWT), walking aid use, and pain scores were collected. Descriptive statistics, -tests, and binary regression models were used.

RESULTS

Five hundred ninety two participants were included: 271 THA (males n = 134, mean age: 66.4) and 321 TKA (males n = 155, mean age: 66.8). THA: At 6 weeks, 155 patients (57.1%) were driving and 116 did not drive (DND) (n = 82 female, 70.6%) ( < .001). SRWT was longer in driving group (mean 36.35 minutes vs 31.23 minutes [ = .072]). TUG tests were faster in driving group (9.51 seconds vs 11.98 seconds [ < .001]). Driving inability predictors included using 2 crutches ( < .001) and TUG ( = .015). TKA: At 6 weeks, 196 patients (61%) were driving and 125 DND (n = 78 female, 62.4%) ( < .01). SRWT was longer in driving group (mean 33.6 vs 28.1 minutes [ = .31]). TUG tests were faster in driving group (10.18 seconds vs 12.29 seconds [ < .001]). Driving inability predictors included "severe" pain scores ( ≤ .0001) and >2 walking aids use ( = .022).

CONCLUSIONS

Following THA/TKA, 60% patients were driving by 6 weeks. Females take longer for driving return. Walking aids negatively impacted driving return, while faster TUG test and longer SRWT were positive predictors.

摘要

背景

全髋关节置换术(THA)/全膝关节置换术(TKA)后一个常见的问题是“医生,我什么时候可以开车?”目前尚无客观评估方法。本研究旨在确定预测髋关节THA和TKA后恢复驾驶的临床因素。

方法

在这项单中心回顾性观察研究中,对THA和TKA术后6周的患者进行了评估。收集了患者的人口统计学信息、驾驶状态、计时起立行走测试(TUG)、自我报告的步行时间(SRWT)、助行器使用情况和疼痛评分。使用描述性统计、t检验和二元回归模型。

结果

共纳入592名参与者:271例行THA(男性134例,平均年龄:66.4岁),321例行TKA(男性155例,平均年龄:66.8岁)。THA:术后6周时,155例患者(57.1%)能够驾驶,116例不能驾驶(DND)(女性82例,占70.6%)(P<0.001)。驾驶组的SRWT更长(平均36.35分钟对31.23分钟[P = 0.072])。驾驶组的TUG测试更快(9.51秒对11.98秒[P<0.001])。无法驾驶的预测因素包括使用双拐(P<0.001)和TUG测试结果(P = 0.015)。TKA:术后6周时,196例患者(61%)能够驾驶,125例不能驾驶(DND)(女性78例,占62.4%)(P<0.01)。驾驶组的SRWT更长(平均33.6分钟对28.1分钟[P = 0.31])。驾驶组的TUG测试更快(10.18秒对12.29秒[P<0.001])。无法驾驶的预测因素包括“严重”疼痛评分(P≤0.0001)和使用超过2种助行器(P = 0.022)。

结论

THA/TKA术后6周时,60%的患者能够驾驶。女性恢复驾驶的时间更长。助行器对恢复驾驶有负面影响,而更快的TUG测试结果和更长的SRWT是恢复驾驶的积极预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ab6/12044195/2b2c254a8b38/gr1.jpg

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