Driving and emergency braking may be impaired after tibiotalar joint arthrodesis: conclusions after a case series
Schwienbacher, Stefan ; Aghayev, Emin ; Hofmann, Ulf ; Jordan, Maurice ; Marmotti, Antongiulio ; Röder, Christoph ; Ipach, Ingmar
In: International Orthopaedics, 2015, vol. 39, no. 7, p. 1335-1341
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- Purpose: To assess whether reaction time (RT) and movement time (MT), as the two components of the total brake response time (TBRT) and brake force (BF) are different in patients with a footjoint arthrodesis in comparison to controls. Methods: The study was a comparative case series in a driving simulator under realistic driving conditions. Mobile patients without a walker, ≥6months after surgery who were driving a car and had no neurological co-morbidity, knee or hipjoint prosthesis were included in the study. The selection criteria resulted in 12 patients with right tibiotalarjoint arthrodesis (TTJA) and 12 patients with another rightfootjoint arthrodesis (OFJA), who were compared to 17 individuals without any ankle-joint pathology. For TBRT, an empirical safe driving threshold of 700ms was used. The outcome measures were RT, MT, TBRT, BF and McGuire score. Results: MT (p = 0.034) and TBRT (p = 0.026) were longer in TTJA patients in comparison with the controls. Also, more patients with TTJA than patients with OFJA and controls exceeded the safe driving threshold (p = 0.028). The outcomes in OFJA patients and in controls were comparable. The McGuire score was similar between the TTJA and OFJA patients (p = 0.26). Conclusions: Significantly slower MT and TBRT, and significantly more patients exceeding the safe driving threshold, were observed after a tibiotalar-joint arthrodesis in comparison to the controls. Patients with OFJAs were not significantly different from the controls. Driving and emergency braking may be impaired after tibiotalar-joint arthrodesis.