When Is It Safe to Return to Driving After Spinal Surgery? Follow-up telephone calls to patients discharged after undergoing orthopaedic surgery: double-blind, randomised controlled trial of efficacy. Influence of left- and right-side total hip arthroplasty on the ability to perform an emergency stop while driving a car. Driving reaction time before and after surgery for lumbar disc herniation in patients with radiculopathy Driving Reaction Time Before and After Primary Fusion of the Lumbar Spine Does the brake response time of the right leg change after left total knee arthroplasty? A prospective study. Self Perceptions as Predictors for Return to Work 2 Years After Rehabilitation in Orthopedic Trauma Inpatients When is it safe for patients to drive after right total hip arthroplasty? Prehabilitation and early rehabilitation after spinal surgery: randomized clinical trial Brake response time after total knee arthroplasty: when is it safe for patients to drive? A prospective study of cognitive behavioural factors as predictors of pain, disability and quality of life one year after lumbar disc surgery Driving reaction time before and after anterior cervical fusion for disc herniation: a preliminary study The relationship between compensable status and long-term patient outcomes following orthopaedic trauma. Utility of Spine Surgery: A Comparison of Common Elective Orthopaedic Surgical Procedures Patients' Satisfaction With Provided Care/Information and Expectations on Clinical Outcome After Lumbar Disc Herniation Surgery The Use of Guided Imagery to Manage Pain in an Elderly Orthopaedic Population Driving reaction time before and after surgery for disc herniation in patients with preoperative paresis.
Study Design Prospect i ve study . Objective Surgeons ’ recommendations for a safe return to driving following cervical and lumbar surgery vary and are based on empirical data . Driver reaction time ( DRT ) is an objective measure of the ability to drive safely . There are limited data about the effect of cervical and lumbar surgery on DRT . The purpose of our study was to use the DRT to determine when the patients undergoing a spinal surgery  may safely return to driving . Methods We tested 37 patients ’ DRT using computer software . Twenty-three patients ( mean 50.5 ± 17.7 years ) received lumbar surgery , and 14 patients had cervical surgery ( mean 56.7 ± 10.9 years ) . Patients were compared with 14 healthy male controls ( mean 32 ± 5.19 years ) . The patients having cervical surgery were subdivided into the anterior versus posterior approach and myelopathic versus nonmyelopathic groups . Patients having lumbar spinal surgery were subdivided by decompression versus fusion with or without decompression and single-level versus multilevel surgery . The patients were tested preoperatively and at 2 to 3 , 6 , and 12 weeks following the surgery . The use of opioids was noted . Results Overall , the patients having cervical and lumbar surgery showed no significant differences between pre- and postoperative DRT ( cervical p = 0.49 , lumbar p = 0.196 ) . Only the patients having single-level procedures had a significant improvement from a preoperative DRT of 0.951 seconds ( st and ard deviation 0.255 ) to 0.794 seconds ( st and ard deviation 0.152 ) at 2 to 3 weeks ( p = 0.012 ) . None of the other subgroups had a difference in the DRT . Conclusions Based on these findings , it may be acceptable to allow patients having a single-level lumbar fusion who are not taking opioids to return to driving as early as 2 weeks following the spinal surgery AIMS AND OBJECTIVES To evaluate the effectiveness of a follow-up telephone call to reduce the number of issues after hospital discharge . BACKGROUND The postdischarge period is often a time of uncertainty and risk . The decreasing length of hospital stays has increased the need for specific instructions about the postdischarge period . A telephone follow-up could be a valuable tool to fill this information gap . DESIGN Double-blind , r and omised controlled trial . METHODS The participants included medium or low-intensity orthopaedic patients . We implemented a structured telephone follow-up call conducted by a senior orthopaedic nurse to provide educational support to the  intervention group ( n = 110 ) , while the control group ( n = 109 )  received routine care after being discharged . Data were collected between September 2011-January 2012 . Statistical differences between the two groups were tested using chi-square test or Wilcoxon rank sum test , as appropriate . A linear regression model was performed to investigate factors involved into postdischarge outcomes . RESULTS The intervention group had a statistically significant reduction in all postdischarge problems except for pain and mobilisation ; the group also had a lower chance of experiencing frequent or severe problems . The educational intervention and prior poor health had a strong correlation with problems after discharge . Patients who received a telephone follow-up call believed the information provided was valuable . CONCLUSION This nurse-led follow-up intervention significantly contributed to solving or reducing postdischarge health problems and contributed to reduce unnecessary burden on the community health system . RELEVANCE TO CLINICAL PRACTICE A nurse-led telephone follow-up is a simple , feasible and low-cost tool to improve patients ' outcomes after discharge OBJECTIVE To show the possible effect of  left- and right-side total hip arthroplasty ( THA )  on the ability to perform an emergency stop when driving a car . DESIGN Inception cohort . SETTING A driving simulator using an actual car cabin , specifically developed for the experiment , was used for testing driving ability . PARTICIPANTS Patients ( N=40 ; 20 left-side THA/20 right-side THA )  were tested preoperatively and in increments of 8 days and 6 , 12 , and 52 weeks after surgery . INTERVENTIONS Left- and right-side THA . MAIN OUTCOME MEASURES Reaction time , movement time , total brake response time ( TBRT ) , and maximum brake force . RESULTS Eight days postoperatively , measurements on driving performance indicated a slight worsening for all outcome parameters in patients after left-side THA and considerably more worsening in patients after right-side THA . For both patient groups , significant improvements in outcome measures were noted during the 1-year follow-up . Brake force declined significantly in patients with left-side THA ( P=.012 ) and in patients after right-side THA ( P<.001 ) . A total of 35 % of the patients with right-side THA and 15 % with left-side THA could not meet the 600 ms TBRT threshold 6 weeks postoperatively . CONCLUSIONS Most patients who underwent right-side THA reached their preoperative baseline 6 weeks after surgery . Most of the patients with left-side THA showed no TBRT limitations 8 days postoperatively . Because of the patients ' highly individual rehabilitation course and considering the possible consequences of the premature resumption of driving a motor vehicle , individual examination and recommendation are necessary Purpose Although patients scheduled to undergo lumbar disc surgery  often ask when they are allowed to drive a motor vehicle again , there are no published recommendations on this subject . Methods We conducted a prospect i ve study in 46 consecutive patients ( mean age 48.9 years ) to determine driving reaction time ( DRT ) before and after surgery in patients with lumbar disc herniation . Of the patients 23 had left-side radiculopathy and 23 right-side radiculopathy .  Driving reaction time as well as back and leg pain were evaluated preoperatively , on the day of discharge from hospital and at the 5-week follow-up examination ( FU ) . 31 healthy subjects were tested as controls . Results Significant improvement in DRT was seen for both patient sample s ( p < 0.05 ) . For patients with a right-side radiculopathy preoperative DRT was 664 ms ( median , IQR : 241 ) , which was reduced to 605 ms ( median , IQR : 189 ) immediately postoperatively and to 593 ms ( median , IQR : 115 ) at FU . For patients with a left-side radiculopathy DRT was 675 ms ( median , IQR : 247 ) preoperatively , 638 ms ( median , IQR : 242 ) postoperatively and 619 ms ( median , IQR : 162 ) at FU . Pain was moderately correlated to DRT . Control subjects had a driving reaction time of 487 ( median , IQR : 116 ) , which differed significantly from patients at all three testing times ( p < 0.001 ) . Conclusion Our data indicate a positive effect of the surgery on driving ability . Therefore , we would suggest that for both patient sample s it is safe to continue driving after hospital discharge . However , patients have to be informed about increased DRT caused by radiculopathy already before surgery Study Design . Controlled prospect i ve study . Objective . To determine whether driving reaction time ( DRT ) is influenced by primary lumbar fusion . Summary of Background Data . The effects of radiculopathy and nerve root blocks on DRT have been reported recently . To our knowledge , the relationship between lumbar fusion and DRT has not been previously studied although it is important for driving safety . The aim of the present study was to test the hypotheses that DRT after lumbar fusion is ( 1 ) altered after the operation , ( 2 ) influenced by pain , ( 3 ) influenced by the patient 's driving skill , and ( 4 ) differs from the DRT of healthy controls . Methods . Twenty-one consecutive patients ( mean age , 53.5 years ; SD 10.8 ) receiving primary lumbar fusion were tested for their DRT 1 day before surgery ( preoperative ) , the day before discharge ( postoperative ) and 3 months after surgery ( follow-up ; FU ) .  DRT  was assessed using a custom-made driving simulator . The severity of back pain was determined on visual analogue scales separately for usual pain ( VAS-U ) and pain during testing ( VAS-T ) . We also determined the patients ' subjective driving frequency . Normative DRT data from 31 age-matched healthy controls were used for comparison . Results . The preoperative DRT was 685 milliseconds ( Md ; IQR 246 ) and the postoperative DRT 728 milliseconds ( Md ; IQR 264 ) , which was further reduced to 671 milliseconds ( Md ; IQR 202 ) after the FU period . Statistical significance was registered between postoperative and FU DRT ( P = 0.007 ) . Moderate to high correlations ( 0.537 < r < 0.680 ) were found between the VAS rating of back pain and DRT . Control subjects had a DRT of 487 milliseconds ( Md ; IQR 116 ) , which differed significantly from the DRT of patients at all 3 time points of testing ( P < 0.001 ) . Conclusion . It appears safe to continue driving after discharge from the hospital following lumbar fusion . DRT improved significantly during FU , indicating a positive effect of the intervention on driving skills . DRT correlates with the severity of back pain Patients undergoing total knee arthroplasty often ask when they can safely resume car driving . There is little evidence available on which physicians can rely when advising patients on this issue . In a prospect i ve study we assessed the brake response time of 24 patients admitted to the clinic for left total knee arthroplasty preoperatively and then 10 days after surgery . On each measurement day the patients performed two tasks , a simple and a complex brake response time task in a car simulator . Ten days after left TKA the brake response time for the simple task had decreased by 3.6 % ( p=0.24 ) , the reaction time by 3.1 % ( p=0.34 ) and the movement time by 6.6 % ( p=0.07 ) . However , the performance improvement was not statistically significant . Task complexity increased brake response time at both time points . A 5.8 % increase was significant ( p=0.01 ) at 10 days after surgery . Based on our results , we suggest that patients who have undergone left total knee arthroplasty may resume car driving 10 days after surgery as long as they drive a car with automatic transmission Purpose This study aim ed to identify self-perception variables which may predict return to work ( RTW ) in orthopedic trauma patients 2 years after rehabilitation . Methods A prospect i ve cohort investigated 1,207 orthopedic trauma in patients , hospitalised in rehabilitation , clinics at admission , discharge , and 2 years after discharge . Information on potential predictors was obtained from self administered question naires . Multiple logistic regression models were applied . Results In the final model , a higher likelihood of RTW was predicted by : better general health and lower pain at admission ; health and pain improvements during hospitalisation ; lower impact of event ( IES-R ) avoidance behaviour score ; higher IES-R hyperarousal score , higher SF-36 mental score and low perceived severity of the injury . Conclusion RTW is not only predicted by perceived health , pain and severity of the accident at the beginning of a rehabilitation program , but also by the changes in pain and health perceptions observed during hospitalisation Old studies recommend 6weeks post-operative before patients can return to driving safely . This is a prospect i ve study assessing brake reaction time ( BRT ) after THA  . 38 patients underwent a pre-operative , 2  ,  4 and 6weeks post-operative BRT test . General linear repeated measurement was used . The mean pre-operative reaction time was 0.635±0.160seconds SD and 2-week was 0.576±0.137seconds SD ( P=0.029 ) ; 33 patients ( 87 % ) were able to reach their baseline time by 2weeks . The remaining five patients ( 13 % ) reached their baseline at the 4-week post-operative . No differences were found with respect to age , gender , and the use of assistive devices . With new techniques in THA , most of patients return to normal times within the 2-week Objective : To evaluate the outcome after spinal surgery when adding prehabilitation to the early rehabilitation . Design : A r and omized clinical study . Setting : Orthopaedic surgery department . Subject : Sixty patients scheduled for surgery followed by inpatient rehabilitation for degenerative lumbar disease . Interventions : The patients were computer r and omized to prehabilitation and early rehabilitation ( 28 patients ) or to st and ard care exclusively ( 32 patients ) . The intervention began two months prior to the operation . The prehabilitation included an intensive exercise programme and optimization of the analgesic treatment . Protein drinks were given the day before surgery . The early postoperative rehabilitation included balanced pain therapy with self-administered epidural analgesia , doubled intensified mobilization and protein supplements . Main measures : The outcome measurements were postoperative stay , complications , functionality , pain and satisfaction . Results : At operation the intervention group had improved function , assessed by Rol and Morris Question naire ( P = 0.001 ) . After surgery the intervention group reached the recovery milestones faster than the control group ( 1—6 days versus 3—13 , P = 0.001 ) , and left hospital earlier ( 5 ( 3—9 ) versus 7 ( 5—15 ) days , P = 0.007 ) . There was no difference in postoperative complications , adverse events , low back pain and radiating pain , timed up and go , sit-to-st and or in life quality . Patient satisfaction was significantly higher in the intervention group compared with the control group . Conclusion : The integrated programme of prehabilitation and early rehabilitation improved the outcome and shortened the hospital stay — without more complications , pain or dissatisfaction Total knee arthroplasty ( TKA ) dramatically decreases pain and improves mobility and quality of life . However , little has been reported on its effect on driving ability in the early postoperative period . This prospect i ve study was conducted to compare preoperative and postoperative brake response times ( BRTs ) in patients undergoing TKA for osteoarthritis . The results showed that patients returned to preoperative BRT as early as 3 weeks after surgery , and at 9 weeks after surgery , BRTs were significantly improved over baseline . Based on BRT analysis patients undergoing TKA  may be allowed to return to driving 6 weeks after surgery Purpose . The primary aim of this study was to analyse the predictive value of cognitive and behavioural factors , in relation to pain , disability and quality of life ( QoL ) one year after lumbar disc surgery . Method . The study design was prospect i ve . Fifty-nine patients scheduled for first time lumbar disc surgery were included .  Pain , disability , QoL , coping , fear avoidance beliefs , expected outcome and sick leave were assessed preoperatively and 12 months after surgery . Multiple backward stepwise logistic regression analyses were performed to study the contribution of the preoperatively measured independent behavioural/cognitive factors ( coping , fear avoidance beliefs and assessed chance to return to work within 3 months ) to the dependent variables pain , disability and quality of life at 12 months after surgery . Results . Low expectations on work return within 3 months after surgery was significantly predictive for residual leg pain , odds ratio ( OR ) = 8.2 , back pain , OR = 9.7 , disability , OR = 13.8 and sick leave , OR = 19.5 . Low QoL , was best predicted by preoperatively high scores on fear avoidance beliefs OR = 6.6 and being a woman OR = 6.0 . The regression model explained 26–40 % of the variance in pain , disability , QoL and sick leave . Conclusions . Eliciting patients ' expectations on work return after surgery could contribute to early identification of those who run the risk of developing long-term disability and sick-leave Purpose Reduced driving reaction time ( DRT ) has already been studied in context with lumbar disc surgeries . Data on whether cervical spine pathologies impair driving abilities are still lacking . In addition , no return-to-driving recommendations after anterior cervical fusion procedures have been published . Therefore , we assessed DRT before and after anterior cervical discectomy and fusion . Methods We performed a prospect i ve study with 12 patients ( mean age 47.2 years ; female 7 , male 5 ) . DRT as well as arm and neck pain were evaluated before surgery , on the day before discharge from hospital and at the 4–6-week follow-up examinations . 31 healthy subjects were tested for DRT  as a control group . Results All patients showed significant improvement in DRT in the longitudinal course ( p < 0.05 ) . DRT was 601 ms ( median , IQR : 63 ) before surgery , which was reduced to 580 ms ( median , IQR : 112 ) on the day before discharge from hospital and to 532 ms ( median , IQR : 48 ) at follow-up examination . Control subjects had a driving reaction time of 487 ms ( median , IQR : 116 ) , which differed significantly from that of patients at all three testing times ( p < 0.05 ) . VAS for arm and neck pain showed significant improvement ( p < 0.05 ) . Conclusion The present results show a positive effect of anterior cervical discectomy and fusion on driving safety . Based on our data we state that it appears to be safe to resume driving after discharge from hospital . However , patients scheduled to undergo anterior cervical discectomy and fusion  should be informed about increased DRT as compared to healthy individuals OBJECTIVE To determine the relationship between compensable status in a " no-fault " compensation scheme and long-term outcomes after orthopaedic trauma . DESIGN AND SETTING Prospect i ve cohort study within two adult Level 1 trauma centres in Victoria , Australia . PARTICIPANTS Blunt trauma patients aged 18 - 64 years , admitted between September 2003 and August 2004 with orthopaedic injuries and funded by the no-fault compensation scheme for transport-related injury , or deemed non-compensable . MAIN OUTCOME MEASURES 12-item Short Form Health Survey ( SF-12 ) and return to work or study at 12 months after injury . RESULTS Of 1033 eligible patients , 707 ( 68.8 % ) provided follow-up data ; 450 compensable and 247 non-compensable patients completed the study . After adjusting for differences across the groups ( age , injury severity , head injury status , injury group , and discharge destination ) using multivariate analyses , compensable patients were more likely than non-compensable patients to report moderate to severe disability at follow-up for the physical ( adjusted odds ratio [ AOR ] , 2.0 ; 95 % CI , 1.3 - 2.9 ) , and mental ( AOR , 1.6 ; 95 % CI , 1.1 - 2.5 ) summary scores of the SF-12 . Compensable patients were less likely than non-compensable patients to have returned to work or study , even after adjusting for injury severity , age , head injury status and discharge destination ( AOR , 0.6 ; 95 % CI , 0.3 - 0.9 ) . CONCLUSIONS Patients covered by the no-fault compensation system for transport-related injuries in Victoria had worse outcomes than non-compensable patients Study Design . A 1-year prospect i ve observational cohort study . Objective . To compare the utility before and 1 year after  elective spine surgery with some other common  orthopaedic surgical procedures .  Summary of Background Data . By using global measures like EQ-5D and SF-36 for the determination of the utility , the changes in quality of life , quality of life ( QoL ) after an intervention different diagnoses , and treatments can be compared . Total hip replacement ( THR ) has become almost golden st and ard in this respect . Methods . Seven hundred seventy-seven subjects with different common orthopaedic diagnoses scheduled for elective surgery were just before surgery and 1 year after surgery answering both EQ-5D and SF-36 .  Four groups with different spine diagnoses and procedures were formed and compared with 8 other diagnoses and treatment groups . Results . Before surgery , subjects with spine diagnoses reported the lowest QoL of all diagnoses compared . Surgery for spinal stenosis , spondylolisthesis , and instability meant the largest improvement of all surgical interventions . Surgery for NHP gave a moderately good improvement , whereas surgery for CLBP only marginally improved those operated . Particularly THR but also TKR more or less completely normalized QoL but made it from a relatively high preoperative level . The greatest improvements after spine surgery , other surgical procedures , and different diagnoses were in the pain/discomfort domain . Conclusion . Spinal surgery in spinal stenosis , spondylolisthesis , and instability had in comparison to other types of elective orthopaedic surgery an outst and ing better ability to improve the operated subject ’s health-related quality of life than other types of elective orthopaedic surgery . The utility of HNP surgery  was somewhat lower and was rather marginal for those operated for nonspecific CLBP Study Design . A prospect i ve study of patients undergoing lumbar disc herniation surgery . Objectives . To assess patients ' satisfaction with care/preoperative information , if expectations on surgical results and ability to return to work are related to baseline characteristics , and /or can predict self-reported outcome . Self-reported outcome was compared with objective outcome . Summary of Background Data . Patients ' expectations on treatment results have been discussed as a predictive factor for postoperative outcome and satisfaction demonstrated to be directly related to patient expectations . Methods . The study includes 148 patients , 46 % women , mean age 40 ( range 18–66 ) . Before and 2 years after surgery , question naires about given information/care , expected/present work ability , and expectations on/obtained improvement of physical functions/symptoms ( leg and back pain , sensibility , and muscle function ) were filled in . The visual analog scale leg pain , Zung Depression Scale , and Oswestry Disability Index were used as baseline characteristics . At 2-year follow-up , self-reported and objective outcome was assessed . Results . Satisfaction with given information/care were reported by 46 % and 82 % , respectively . Zung Depression Scale related to expectations on leg pain recovery ( P = 0.022 ) , work ability ( P = 0.046 ) , and satisfaction with given information ( P = 0.031 ) . Patients who expected to return ( 76 % ) and not return ( 24 % ) to work , returned in 78 % and 26 % , respectively ( P = 0.021 ) . A high agreement between self-reported outcome and objective outcome were found ( P < 0.001 ) . Conclusions . Patients undergoing lumbar disc herniation surgery are mostly satisfied with provided care before and after surgery , however , less satisfied with information provided . Further , patients with preoperative positive expectations on work return and realistic expectations on pain and physical recovery have a greater chance to be satisfied with the surgical results BACKGROUND : The management of postoperative pain in elderly orthopaedic patients is critical for advancing patient outcomes and improving the use of healthcare re sources . Adequate pain control without adverse side effects , such as confusion and sedation , is crucial to promote comfort and participation in rehabilitation therapies among all patients but particularly among elderly joint replacement patients . Without adequate pain control , physical therapy is delayed and the risk of complications increases . One area of investigation that holds promise for improved treatment outcomes involves the use of complementary therapies , such as guided imagery . PURPOSE : The purpose of this pilot study was to test the effects of a guided imagery intervention in the older adult patient who has undergone joint replacement surgery . SAMPLE AND METHODS : This pilot study used a two-group experimental repeated measures design . A sample of 13 patients , age 55 years and older , were recruited . The control group received usual care and a music audio tape . The experimental group received usual care and a guided imagery audio tape intervention . FINDINGS AND DISCUSSION : Trends in this pilot study demonstrated positive outcomes for pain relief , decreased anxiety , and decreased length of stay .  Complementary therapy holds the promise of increasing positive outcomes . Further research is needed to vali date these findings with a larger postoperative sample and in other population s as well . CLINICAL IMPLICATION S : There is a critical need to incorporate the use of guided imagery and other complementary therapies into all nursing curricula . Nurses must develop expertise and be ready and able to act as patient educators and advocates in the use of these interventions in programs of care and institutional policy BACKGROUND CONTEXT The effect of many types of surgeries on driving reaction time ( DRT ) has been reported . Although lumbar disc herniation is one of the most common spinal diseases , the effect on DRT has not been investigated . PURPOSE To assess the effect of left- and right-sided pareses caused by lumbar disc herniation on DRT before and after surgery . STUDY DESIGN Controlled prospect i ve clinical trial . PATIENT SAMPLE Patients undergoing disc surgery .  OUTCOME MEASURES Impact of paresis caused by lumbar disc herniation and disc surgery on DRT . METHODS Forty-two consecutive patients ( mean age , 50.3 years ) were tested for  DRT  1 day before surgery , postoperatively before hospital discharge , and 5 weeks after surgery . Visual analogue scale ( VAS ) for back and leg pain as well as pain medication and patients ' driving frequency were recorded . RESULTS Significant improvement of DRT after surgery was seen in patients with left- and right-sided pareses ( p<.005 ) . For the right-sided paresis group , the preoperative DRT was 761 ms ( median , interquartile range [ IQR ] : 490 ) , 711 ms ( median , IQR : 210 ) immediately postoperatively , and 645 ms ( median , IQR : 150 ) at follow-up ( FU ) . For the left-sided paresis group , DRT was 651 ms ( median , IQR : 270 ) preoperatively , 592 ms ( median , IQR : 260 ) postoperatively , and 569 ms ( median , IQR : 140 ) at FU . Significant differences between right- and left-sided pareses were identified preoperatively and at FU testing ( p<.005 ) . No correlation was found between VAS for leg or back pain and DRT . Historical control subjects had a DRT of 487 ( median , IQR : 116 ) , which differed significantly at all three test times ( p<.001 ) . CONCLUSIONS A significant reduction in DRT in patients with right- and left-sided pareses was found after surgery , indicating a positive effect of surgery . The improvement in DRT seen immediately postoperatively and the lack of a generally accepted threshold for DRT would suggest that for both patient sample s , it is safe to continue driving after hospital discharge . However , patients should be informed accordingly
Observer-reported outcome measures showed that patients ’ driving abilities often are impaired when wearing an immobilizing cast above or below the elbow or a shoulder sling on their dominant arm .
Conclusions The available evidence provides a best-case scenario for when patients can return to driving .
Survey data suggest that patients are returning to driving before observer-reported outcome measures have normalized , indicating that physicians should tell patients to wait longer before driving .
Background Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures , but the data regarding this topic are diverse and sometimes conflicting .
Some studies provide observer-reported outcome measures , such as brake response time or simulators , to estimate when patients can safely resume driving after surgery , and patient survey data describing when patients report a return to driving , but they do not all agree .
We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive .
Questions / purpose sBased on the available evidence , we sought to determine when patients can safely return to driving after ( 1 ) lower extremity orthopaedic surgery and injuries ; ( 2 ) upper extremity orthopaedic surgery and injuries ; and ( 3 ) spine surgery .