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Mother had a knee replacement four weeks ago and insists she is perfectly capable of driving now. We are equally willing to take her wherever she wants to go and whenever she wants to go. What can we do to slow down the speed at which she wants to move after a major surgery like this?

Surgeons say that one of the first questions many patients ask about recovery after a total knee replacement is, "How soon can I drive again?" Driving is often the key to independence for seniors. This is true even when family members (and friends) are willing to drive them anywhere anytime or when public transportation is available. Delaying a return-to-driving if it is not necessary may create a great deal of inner family conflict. Studies are few and far between on this topic but what we can relay what has been reported. Perhaps this information will help calm your fears. The usual guideline for return-to-driving is six to eight weeks after surgery. Driving restrictions primarily apply to patients who have had a right knee replacement (assuming they drive an automatic vehicle). The question has come up about getting back behind the wheel sooner with the new and improved implant procedures. With less soft tissue disruption, muscle strength and motor control should come back even faster than with traditional procedures. And, in fact, studies show that improved surgical techniques, better pain control, and advanced rehab protocols have now put patients back in the driver's seat much faster. With less pain, faster return of knee motion and mobility, patients experience better function sooner. Many patients feel ready to quickly regain the social independence driving provides. The patient's age and gender don't seem to make a difference in reaction time when going from acceleration (gas pedal) to braking. A recent study of brake reaction times showed that patients with a right knee replacement preoperative regained their preoperative braking reaction time by the end of four weeks. If brake reaction time were the only criteria for return-to-driving, then many of the patients would have been ready at the end of two weeks. But there are other factors to be considered that weren't tested for such as vision, overall reaction time, effect of narcotics or other medications, and other health concerns. Future studies will be needed to continue investigating this topic and forming guidelines for return-to-driving after right knee replacement. Separate testing should be done for automatic versus standard transmission vehicles. Any one who passes the brake test but who might need additional testing can be evaluated more completely with an on-the-road test.

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