Driving After Total Ankle Arthroplasty

Background: The purpose of the study was to determine when patients can safely return to driving after total ankle arthroplasty.

Methods: After institutional review board approval, forty-nine patients undergoing total ankle arthroplasty were recruited prospectively. Patients’ brake reaction time (BRT) was tested at six weeks and repeated until patients achieved a passing BRT. A control group of twenty healthy patients was used to establish as passing BRT. Patients were given a validated novel driver readiness survey to complete.

Results: Forty-nine patients were enrolled. Patient demographics include an age range of 43 to 83 years (mean 63 years), of which 30 were male (61%) and 19 were female (39%). At 6 weeks, 44 of the 49 patients (89%) had BRT less than 0.850 seconds and were considered safe to drive. At 6 weeks, the passing group average BRT was 0.628 seconds. At 9 weeks, 46 patients (100%) of those who completed the study achieved a passing BRT. Patients that failed at 6 weeks had statistically greater visual analog scale (VAS) for pain (p=0.041) and significantly diminished plantarflexion (p=0.035). Notably, there was no significant difference in failure rates when measuring dorsiflexion (p=0.704). On the validated novel driver readiness survey, 5 of the 5 patients (100%) who did not pass neither agreed nor disagreed, disagreed or strongly disagreed with the statement, “Based on what I think my braking reaction time is, I think that I am ready to drive.”

Conclusion: Patients may be informed that they can safely return to driving 9 weeks after total ankle arthroplasty. Some patients may be eligible to return to driving at 6 weeks depending on their VAS, plantarflexion, and driver readiness survey results.