September 2015 CME Article No. 9: Brake Response Time is Significantly Impaired after Total Knee Arthroplasty

Additional Information

Objective:
The objective of this study was to investigate whether total knee arthroplasty (TKA) impairs the ability to perform an emergency stop.

Design:
An automatic transmission brake simulator was developed to evaluate total brake response time. A prospective repeated-measures design was used. Forty patients (20 left/20 right) were measured 8 days and 6, 12, and 52 wks after surgery.

Results:
Eight days postoperative total brake response time increased significantly by 30% in right TKA and insignificantly by 2% in left TKA. Brake force significantly decreased by 35% in right TKA and by 25% in left TKA during this period. Baseline values were reached at week 12 in right TKA; the impairment of outcome measures, however, was no longer significant at week 6 compared with preoperative values. Total brake response time and brake force in left TKA fell below baseline values at weeks 6 and 12. Brake force in left TKA was the only outcome measure significantly impaired 8 days postoperatively.

Conclusion:
This study highlights that categorical statements cannot be provided. This study's findings on automatic transmission driving suggest that right TKA patients may resume driving 6 wks postoperatively. Fitness to drive in left TKA is not fully recovered 8 days postoperatively. If testing is not available, patients should refrain from driving until they return from rehabilitation.

Learning Objectives:

List important parameters of driving ability
Describe the effect of TKA on driving parameters
Formulate an individualized treatment plan to return patients to safe driving after TKA

Summary


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