Driving following acute lower limb painful events

SUMMARY Orthopedic procedures or injuries can temporarily prevent patients from driving. The time duration until they can resume driving has significant financial, medico-legal and legal implications on the patient, physician and society. There are a few guidelines about driving restrictions following acute lower limb events, however, the time duration varies among jurisdictions. The current published recommendations vary from no driving abstinence to 9 weeks, depending on the affected side, procedure, immobilization, pain level and type of car (automatic vs manual). There is also individual variability in patients with respect to their pain, comorbidities and prior driving experience. The decision to allow a patient to drive is often made clinically by the treating physician, but there is no consensus among orthopedic surgeons about driving restrictions. The use of opioid analgesic medications is regarded as an important factor in the decision to restrict driving. In this article, we review the current guidelines and clinical studies available for acute lower limb injuries or interventions including total hip arthroplasties and total knee arthroplasties, knee arthroscopies, anterior cruciate ligament reconstruction and lower extremity fractures.