title: Influence of left- and right-side total hip arthroplasty on the ability to perform an emergency stop while driving a car.
abstract: 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.
  
  
  METHODS
  Inception cohort.
  
  
  METHODS
  A driving simulator using an actual car cabin, specifically developed for the experiment, was used for testing driving ability.
  
  
  METHODS
  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.
  
  
  METHODS
  Left- and right-side THA.
  
  
  METHODS
  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.
authors.affiliation: Department of Orthopedic Surgery, University Hospital of Tuebingen, Tuebingen, Germany.
authors.forename: Maurice
authors.initials: M
authors.lastname: Jordan
authors.affiliation: Department of Orthopedic Surgery, University Hospital of Tuebingen, Tuebingen, Germany.
authors.forename: Ulf Krister
authors.initials: UK
authors.lastname: Hofmann
authors.affiliation: Department of Orthopedic Surgery, University Hospital of Tuebingen, Tuebingen, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Grünwald
authors.affiliation: Department of Orthopedic Surgery, University Hospital of Tuebingen, Tuebingen, Germany.
authors.forename: Morten
authors.initials: M
authors.lastname: Meyer
authors.affiliation: Department of Orthopedic Surgery, University Hospital of Tuebingen, Tuebingen, Germany.
authors.forename: Saskia
authors.initials: S
authors.lastname: Sachsenmaier
authors.affiliation: Department of Orthopedic Surgery, University Hospital of Tuebingen, Tuebingen, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Wülker
authors.affiliation: Department of Orthopedic Surgery, University Hospital of Tuebingen, Tuebingen, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Kluba
authors.affiliation: Department of Orthopedic Surgery, University Hospital of Tuebingen, Tuebingen, Germany; Department of Orthopedic Surgery, Hospital of Ingolstadt, Ingolstadt, Germany. Electronic address: IngmarIpach@gmx.de.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Ipach
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D001334:Automobile Driving; D005260:Female; D006615:Hip / Q000503:physiopathology*; D006801:Humans; D007866:Leg / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009068:Movement; D053580:Muscle Strength; D011184:Postoperative Period; D011930:Reaction Time / Q000502:physiology; D013647:Task Performance and Analysis
keywords: Arthroplasty; Automobile driving; Hip replacement; Rehabilitation