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Guidelines for Driving after Total Hip Replacement

Posted on: 10/12/2003
Imagine not being able to drive to work, to run errands, to concerts or movies, or to visit friends and family. At first this might seem like a nice break from your hectic pace of life. After all, riding the bus can be fun, and you can catch up on your reading.

But what if you live in a place where there's no bus service? Now imagine you've had a total hip replacement (THR) and can't walk to the bus stop or step up on the bus. Suddenly the value of driving increases more than ever. How soon can you get back behind the wheel after a THR?

Many doctors advise waiting four to six weeks. This gives the soft tissues a chance to heal. However, no one knows if this is a safe recommendation. To help with this decision-making process, a group of physical therapists studied 90 patients after THR. They measured the patients' reaction time. Reaction time is how long it takes for the patient to react to a red traffic light and brake the car.

A driving simulator system with an automatic timer was used. Only English-speaking drivers with a current license were included in the study. The cars had to have an automatic transmission. Patients used the right foot for the gas and brake. Patients ranged in age from 34 to 85 years. Patients' reaction times after THR were compared to normal reaction times published by the American Automobile Association (AAA).

The authors reported a general pattern of worse reaction times for everyone one week after the operation. One year after the operation women had better reaction times than men. This was true even though men had faster times before the THR. Based on the findings of this study, the following guidelines are proposed for driving after a hip replacement:

  • Patients may resume driving an automatic car after one week when the
    left hip has been replaced (provided they drive a vehicle with the steering wheel on the left).

  • Patients who have the right hip replaced should wait four to six weeks to resume driving.

  • A reaction time of 0.50 seconds after a right THR may be the goal. (More study is needed before this is decided.)

  • The patient must be able to follow all precautions when getting in and out of the car. This helps prevent a hip dislocation.

  • Any vehicle or car that puts the knee higher than the hip is not allowed without the doctor's approval.

    These guidelines assume two variables. First, it is assumed that the driver operates the vehicle from the left side. Second, it is assumed that the new hip joint was put in from the back and side of the thigh (posterolateral approach).

  • References:
    Sandy B. Ganz, PT, MS, et al. Improvement in Driving Reaction Time after Total Hip Arthroplasty. In Clinical Orthopaedics and Related Research. August 2003. Vol. 413. Pp. 192-200.

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