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Doctor, When can I drive safely after my Anterior Cruciate Ligament surgery?
Author(s):
Valentí A. (Spain)
,
Valentí A. (Spain)
Affiliations:
Payo J.
,
Payo J.
Affiliations:
Pérez Mozas María
,
Pérez Mozas María
Affiliations:
Lamo de Espinosa J.
,
Lamo de Espinosa J.
Affiliations:
Valentí J.
Valentí J.
Affiliations:
ESSKA Academy. Valentí A. 05/09/18; 209438; P05-1021
Andrés Valentí
Andrés Valentí
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Abstract
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Objectives: To assess the aptitude to regain driving skills and brake reaction after anterior cruciate ligament (ACL) surgery and to determine the ACL reconstruction side influence in real driving situations with use of a driving simulator.

Methods: This study compared the ability and skill driving in thirty-one patients who underwent ACL reconstruction with hamstring autograft at 4-6 weeks after surgery with thirty-one healthy volunteers.
Multiple variables, including pedestrian impact, car crash, red traffic light violations, visual reaction time and other driving abilities were measured with a validated driving simulator (manual transmission). The test consisted in a continuous driving test of 20 kilometers that runs along a circuit that includes an urban area, a highway and a mountain road with traffic and signal traffic as a real driving environment.

We used T-Student test to analyze differences between ACL reconstruction group versus healthy volunteers group when variance homogeneity was confirmed. If the normal distribution could not be assumed a non-parametric test was used such as U-Man Whitney test. We used Wilcoxon sing-rank test to evaluated Lysholm knee scale and the visual analogue scale. All statistical tests were carried out using Stata software 12.0 version

Results: There was no statistically significant difference between groups with respect to skill, driving ability and brake response (P > 0.05). However, in patients with a right ACL reconstruction had more number of collisions with fixed objects (2.82 versus 1.84, P = 0.239), pedestrian impact (0.23 versus 0, P = 0.221) and they were slower in brake reaction (585.69 milliseconds versus 456.02 milliseconds, P = 0.069). Tegner score was similar in each group (7.19 in ACL reconstruction group versus 6.8 in control group, P = 0.092) and the Lyshom score had improved compared to the pre-surgical measurement (53.48 versus 89.61, P < 0.001). Visual analogue score showed no alterations and was similar before and during the driving test (0 versus 0.35, P = 0.183).

Conclusions: ACL autograft surgery not results in a decrease in driving performance and safety at 4-6 weeks after surgery with respect to skill, ability to drive and brake response in a simulated driving circuit.

Patients with right ACL reconstruction, had a tendency with no statistical significance to have more number of collisions with fixed objects, pedestrian impact and they were slower in visual reaction time test. Therefore, in these patients we must be especially careful in our recommendations about driving.

Keywords:
Anterior cruciate ligament reconstruction. Automobile driving. Driving reaction time. Brake response time.
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