Changes in Driving Performance Following Shoulder Arthroplasty.
BACKGROUND
With this study, we sought to quantify perioperative changes in driving performance among patients who underwent anatomic or reverse shoulder arthroplasty.


METHODS
Using a driving simulator, 30 patients (20 anatomic and 10 reverse total shoulder arthroplasties) were tested preoperatively and at 2 weeks (PO2), 6 weeks (PO6), and 12 weeks (PO12) postoperatively. The total number of collisions, centerline crossings, and off-road excursions (when the vehicle traversed the lateral road edge), and scores on a visual analog scale (VAS) for pain and the Shoulder Pain and Disability Index (SPADI) were recorded at each driving trial.


RESULTS
The mean number of collisions increased from 5.9 preoperatively to 7.4 at PO2 and subsequently decreased to 5.6 at PO6 and 4.0 at PO12 (p = 0.0149). In addition, the number of centerline crossings decreased from 21.4 preoperatively to 16.3 at PO12 (p < 0.05). Multivariate analysis of the data demonstrated that increased VAS for pain scores, older age, and less driving experience had a negative impact on driving performance.


CONCLUSIONS
Driving performance returned to preoperative levels at 6 weeks after shoulder arthroplasty. By 12 weeks postoperatively, patients demonstrated improved driving performance compared with preoperative performance. On the basis of our findings, clinicians can suggest a window of 6 to 12 weeks postoperatively for the gradual return to driving. However, for patients of older age, with less driving experience, or with greater pain, a return to driving at closer to 12 weeks postoperatively should be recommended.


METHODS
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY saqib.hasan@nyumc.org.
Saqib
S
Hasan
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
Alan
A
McGee
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
Garret
G
Garofolo
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
Mathew
M
Hamula
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
Cheongeun
C
Oh
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
Young
Y
Kwon
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
Joseph
J
Zuckerman
D000368:Aged; D000072228:Arthroplasty, Replacement, Shoulder; D001334:Automobile Driving; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology*; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014584:User-Computer Interface