Return to Driving After Anterior Total Hip Arthroplasty

Background: Traditional guidance after posterior-approach total hip arthroplasty (THA) recommends return to driving at 6–8 weeks. Muscle-sparing direct anterior THA (A-THA) may enable earlier recovery. Our objective was to assess brake reaction time (BRT) before and after right and left A-THA. Materials and Methods: This is a prospective cohort study of 32 patients who underwent an A-THA (21 right, 11 left). BRTs were recorded using Vericom's stationary reaction timer and response software at the patient's last preoperative visit and at 2 and 6 weeks postoperatively. Pain was assessed during each visit using the visual analog scale (VAS); an Oxford Hip Score (OHS) was filled out at the preoperative and 6-week visits. Results: For patients undergoing right A-THA, mean BRT improved from 0.67 seconds (s) (±0.15) preoperatively to 0.60s (±0.05) at 2 weeks ( P = .01) and 0.58s (±0.06) at 6 weeks ( P = .03). Eighteen of 21 (85.7%) reached or surpassed baseline by 2 weeks. OHS improved from 36 to 19, and VAS improved from 2.9 to 0.24. Right-foot brakers undergoing left A-THA exhibited no significant BRT change: 0.63s (±0.13) preoperatively; 0.60s (±0.11) at 2 weeks, P = .53; and 0.58s (±0.07) at 6 weeks, P = .31. OHS improved from 37 to 20, and VAS did not change significantly. Conclusion: Our objective data support consideration of earlier return to driving after A-THA when patients are off narcotics and meet local/insurer requirements.