title: A Novel Assessment of Braking Reaction Time Following THA Using a New Fully Interactive Driving Simulator.
abstract: BACKGROUND
  After total hip replacement surgery, patients are eager to resume the activities of daily life, particularly driving. Most surgeons recommend waiting 6 weeks after surgery to resume driving; however, there is no evidence to indicate that patients cannot resume driving earlier.
  
  
  OBJECTIVE
  Our purpose was to evaluate when in the recovery period following THA that patients regain or improve upon their preoperative braking reaction time, allowing them to safely resume driving.
  
  
  METHODS
  We measured and compared pre- and postoperative braking reaction times of 90 patients from 3 different surgeons using a Fully Interactive Driving Simulator (Simulator Systems International, Tulsa, OK). We defined a return to safe braking reaction time as a return to a time value that is either equal to or less than the preoperative braking reaction time.
  
  
  RESULTS
  Patients tested at 2 and 3 weeks after surgery had slower braking reaction times than preoperative times by an average of 0.069 and 0.009 s, respectively. At 4 weeks after surgery, however, patients improved their reaction times by 0.035 s (p = 0.0398). In addition, at 2, 3, and 4 weeks postoperatively, the results also demonstrated that patient less than 70 years of age recovered faster.
  
  
  CONCLUSIONS
  Based upon the results of this study, most patients should be allowed to return to driving 4 weeks following minimally invasive primary total hip arthroplasty.
authors.affiliation: Adult Reconstruction and Joint Replacement Service Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Allison V
authors.initials: AV
authors.lastname: Ruel
authors.affiliation: Epidemiology and Biostatistics Core, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Yuo-Yu
authors.initials: YY
authors.lastname: Lee
authors.affiliation: Adult Reconstruction and Joint Replacement Service Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: John
authors.initials: J
authors.lastname: Boles
authors.affiliation: Adult Reconstruction and Joint Replacement Service Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Boettner
authors.affiliation: Adult Reconstruction and Joint Replacement Service Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Edwin
authors.initials: E
authors.lastname: Su
authors.affiliation: Adult Reconstruction and Joint Replacement Service Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Westrich
keywords: THA; braking reaction time; driving simulator; return to driving