2009 Annual Meeting Poster Presentations
Driving Reaction Time After Right Knee Anterior Cruciate Ligament Reconstruction
Poster Presentation Number: P421 Location: Venetian/Sands EXPO Hall DSports Medicine/Arthroscopy
Scott Goldsmith, MD Brandon FLPam J Walsh Brooklyn NY
Orrin H Sherman, MD New York NY
Laith M Jazrawi, MD New York NY
Robert J Meislin, MD New York NY
Andrew S Rokito, MD New York NY
Vivek Pinto Astoria NY
Ali Sheikhzadeh, MD New York NY
Bradley R Wasserman, MD New York NY
Patients receiving autografts achieve braking time equal to healthy controls 6 weeks following surgery, while patients undergoing autograft reconstruction may normalize by as early as 3 weeks.
The number of anterior cruciate ligament (ACL) reconstruction surgeries performed in the United States has markedly increased over the last twenty years. Rehabilitation protocols have also changed, including more aggressive regimens that promote a quicker return to activities of daily living. Factors affected by this procedure include proprioception, coordination, muscle strength, endurance and the ability to drive an automobile. The appropriate length of time prior to safe return to driving after right knee arthroscopic ACL reconstruction remains largely unknown and without scientific basis. As the majority of patients undergoing ACL reconstructions are of driving age, braking reaction time, coordination and timing can all affect safe driving and all are adversely affected following surgery, which may lead to significant social and economic costs. The goal of this study was to determine when patients recover the ability to safely operate an automobile after a right knee arthroscopic ACL reconstruction.
Prospective, case-controlled study of lower extremity driving function amongst thirty patients who have undergone right knee ACL reconstruction (10 with bone-patellar-tendon-bone autograft, 10 with hamstring autograft and 10 with allograft) compared with 20 healthy control subjects. Patients and controls were tested using a driving simulator in various driving conditions. Each patient was evaluated at post-operative intervals of 7-10 days, 3 weeks and 6 weeks. The 3 clinical variables assessed were the time from stimulus to touching the brake, time from touching the brake to full-stop and time from the stimulus to full-stop.
Braking reaction time was significantly delayed in all patients compared to the controls at 7-10 days following surgery. By six weeks post-operatively, the total braking time and driving function of patients who have undergone right knee ACL reconstruction returned to the baseline value as measured by the control group. The allograft patients trended toward a return to the control braking time at the three week interval.
The study provides baseline measures on advising patients about return to driving after ACL reconstruction. Future studies directed at patient education and driving school intervention may return patients to normal control levels sooner.
A · to the left of the title indicates the FDA has not cleared the drug or device for the described purpose.
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