Can you drive 2 weeks after hip surgery?

Return to driving is an important functional landmark for patients and so is one of the most frequently asked questions asked by patients undergoing hip and knee replacement.
However, despite the importance that patients attach to this, there is actually very little in the way of regulation or formal guidelines.
Licensing authorities do not detail or specify specific driving restrictions after hip or knee replacement. Instead, this is left to the discretion of the treating doctor.

The position statement of the Australian Orthopaedic Association and the Arthroplasty Society of Australia published in 2016 simply and vaguely advises that patients should not return to driving until:
i) They no longer require narcotic (strong) analgesia and
ii) They can “safely perform an emergency stop”.

The AOA position statement further states that the ability to perform an emergency stop varies between patients, but that in most cases this occurs between 4 and 6 weeks following a right hip or knee replacement.

However, the confusing issue is that this guideline was formulated by a group of senior surgeons who generally perform “traditional” approach hip replacement which involves cutting and then repairing muscles/tendons to the hip.
In many respects, it is this muscle/tendon injury and repair which impairs a patient’s ability to move their leg confidently in the first few weeks post surgery.

In my experience, patients who have an anterior approach hip replacement (which performed between muscles to the hip with no muscles cut) are often able to discard their pain medications after only a few days and are often off crutches less than a week after surgery.
As muscles to the hip are not cut in the anterior approach, patients can often ambulate independently, safely and confidently earlier than traditional approaches.

I am, therefore, not particularly surprised when patients coming for their 2 week post op check up now often walk up the stairs to my office without crutches and when some tell me that they drove themselves in for the appointment (2 weeks after surgery).

I fully agree with the AOA statement in that patients needs to be off narcotic meds and be able to perform an emergency stop but find that functional recovery after hip replacement is now quicker that was traditionally expected.

Therefore, this is what I now tell patients who ask about return to driving:

  1. You need to off the narcotic (strong) pain meds.
  2. You need to be able to off the walking aids (crutches, walker etc).
  3. You need to have seen the physiotherapist and they need to test and independently confirm that you have good reflexes and muscle strength and be able to react quickly (i.e to be able to perform an emergency stop).
  4. If you had surgery on your left (i.e. non braking) hip or knee, some patients are able to achieve the above as soon as 1 week after surgery (but everyone is different)
  5. If you had surgery on your right side, many patients can achieve this by 2-3 weeks post surgery but these are not fixed dates and everyone is different.  (According to recent research, 87% of patients achieve their baseline by 2 weeks).
  6. If you or your physiotherapist are unsure, it is best to wait until you see me for the 2 week post op checkup and we can review things there. In many cases, patients are back driving close to or soon after that 2 week checkup.
  7. When you do go back to driving, be sensible. Be mindful that your response times might still not be fully normal, so limit your driving initially to good weather, with good visibility conditions,  keep a safe following distance and at first limit your driving to short local routes that you know well.
  8. If you are ever unsure, it is best to take a safety first approach and delay return to driving until you and your physiotherapist feel that you are ready.

This protocol is supported by recent orthopaedic research:

  • When is it safe to resume driving after total hip and total knee arthroplasty? a meta-analysis of literature on post-operative brake reaction times.
    van der Velden CA, Tolk JJ, Janssen RPA, Reijman M .Bone Joint J. 2017 May;99-B(5):566-576.
  • Driving After Microinvasive Total Hip Arthroplasty. J Arthroplasty. 2017 May;32(5):1525-1529.  Qurashi S, Chinnappa J, Lord SJ, Nazha A, Gordon J, Chow J.
  • When is it safe for patients to drive after right total hip arthroplasty? J Arthroplasty. 2015 Apr;30(4):627-30.  Hernandez VH, Ong A, Orozco F, Madden AM, Post Z.

How soon after hip replacement surgery can you drive?

Driving. If you had surgery on your right hip, it may take up to a month to be able to drive safely again. If it was your left hip, then you might be back in the driver's seat in one or two weeks.

What should I be doing 2 weeks after hip replacement?

One or two weeks after surgery you'll probably be able to:.
Move about your home more easily..
Walk short distances, to your mailbox, around the block, or perhaps even further..
Prepare your own meals. One to 2 weeks after surgery you may be able to stand at the kitchen counter without a walking aid. ... .
Take showers..

How far should you walk 2 weeks after hip replacement?

Patients who have superPATH, direct superior, or anterior hip replacement approach in an Ambulatory Surgery Center begin walking an hour after surgery; they no longer require a walker after 1-5 days; and it usually takes them 2-4 weeks to build up to walking a mile in 20 – 30 minutes.