IOA 2022

Return to Driving Following Hip Arthroscopy: A Systematic Review and Meta-Analysis

Roy Assaf Ilan Mitchnik Yiftah Beer Gabriel Agar Dror Lindner Ron Gilat
Department of Orthopedic Surgery, Shamir Medical Center, Israel

Background:
 One of the first questions patients ask their physician after orthopedic surgery is when they can safely resume driving. Hip arthroscopy is an increasingly common procedure, with a 365% increase in yearly rate between the years 2004-2009 in the U.S. Recommendations for return to driving after hip arthroscopy are controversial and vary among surgeons. The aim of this study is to assess current available evidence on the optimal time to safely return to driving after hip arthroscopy.

Methods:
A Systematic review was performed in accordance with the PRISMA guidelines. A literature search was performed using the following databases: PubMed, Google Scholar, Embase, and Cochrane. Five articles met the inclusion criteria. All included articles used observer-reported outcome measures such as break reaction time (BRT). BRT has been found to be one of the most important variables predicting safety to return to drive after surgery.

Results:
Included studies evaluated safety to return to drive after hip arthroscopy in a total of 160 patients. Of these, 142 patients were treated for femoroacetabular impingement (FAI) and 18 patients undergone other hip arthroscopy procedures. Mean weighted age was 33.8 years, with 48.1% females. Right hip affected in 84, left hip in 17, and laterality not reported in 59 patients. Preoperative range of BRT was 566-1960ms. Postoperative BRT range at 1-2 weeks was 567-1,840ms, and at 3-12 weeks 523-1,860ms. Meta-Analysis for included studies showed no significant differences between pre- and postoperative BRT measurements in first 8 postoperative weeks.

Conclusions:
Driving performance returns to the preoperative level as early as two weeks after hip arthroscopy for FAI, and after one week for other hip arthroscopy procedures. Further high-quality studies are needed to assess postoperative incidence and severity of motor vehicle accidents and the effect of other factors such as laterality and manual vs automatic transmission.