Aim. The purpose of this study is to systematically review patient characteristics and clinical determinants that may influence return to driving status and time frames following a primary TKA or THA and provide an update of the current literature. Methods. This review was completed per the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Final electronic database searches were completed in October 2019 in Medline/PubMed, Medline/OVID, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Library using preselected search terms. Manuscripts of prospective and nonrandomized studies that examined the return to driving a car after a primary knee or hip arthroplasty patients were included. The Methodological Index for Non-Randomized Studies was used to measure study quality. Two authors selected studies and assessed their qualities. All disagreements were resolved through discussion and, as needed, a third reviewer. Data on study title, author(s), country, year, study design, sample size, inclusion and exclusion criteria, age, BMI, gender, statistical analyses, driving measure, follow-up time, surgical approach, laterality, and postoperative management were extracted from each study. Results. A total of 23 studies were eligible, including 12 TKA studies () with mean ages between 43 and 82 years, 9 THA studies () with mean ages between 34 and 85 years, and 2 combined TKA and THA (TKA, ; THA, ), yielded MINORS scores between 6 and 12. Most patients achieved or exceeded preoperative response times between 1 and 8 weeks following a TKA and 2 days to 8 weeks following a THA, and/or self-reported return to driving between 1 week and 6 months. Influences on return to driving time included laterality and pain, but gender was mixed. Discussion/Conclusions. Study results were consistent with previous systematic reviews in that return to driving a car after a primary TKA or THA is highly variable, and most commonly occurs around 4 weeks, but can range between 2 and 8 weeks. While various patient and clinical factors can influence return to driving for a TKA or THA, the most common contributing facts were pain and laterality. The heterogeneous nature of the studies prevented a meta-analysis for determining contributions of return to driving following a primary TKA or THA. Regardless, this study updates previous systematic reviews and presents insight on patient and clinical factors beyond generalized timeframes for return to driving a car. This information and results from future studies are essential to guide clinical recommendations and patient and clinician expectations for return to driving a car after a primary TKA or THA.

中文翻译：

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全膝关节或髋关节置换术后重返驾驶汽车的临床考虑：系统评价。

瞄准。本研究的目的是系统回顾可能影响初次 TKA 或 THA 后恢复驾驶状态和时间框架的患者特征和临床决定因素，并提供当前文献的更新。方法. 本次审查是根据系统审查和元分析 (PRISMA) 指南的首选报告项目完成的。最终的电子数据库搜索已于 2019 年 10 月在 Medline/PubMed、Medline/OVID、护理与联合健康文献累积索引 (CINAHL) 和 Cochrane 图书馆中使用预选的搜索词完成。前瞻性和非随机研究的手稿检查了原发性膝关节或髋关节置换术患者恢复驾驶汽车的情况。非随机研究方法学指标用于衡量研究质量。两位作者选择了研究并评估了它们的质量。所有分歧均通过讨论解决，并根据需要由第三位评审员解决。有关研究标题、作者、国家、年份、研究设计、样本量、纳入和排除标准、年龄、BMI、性别、结果。共有 23 项研究符合条件，包括 12 项 TKA 研究（)平均年龄在 43 至 82 岁之间，9 项 THA 研究 ()，平均年龄在 34 至 85 岁之间，2 名 TKA 和 THA 组合（TKA，; 太，)， MINORS 评分在 6 到 12 之间。大多数患者在 TKA 后 1 到 8 周和 THA 后 2 到 8 周内达到或超过术前反应时间，和/或自我报告在 1 到 6 周之间恢复驾驶个月。对恢复驾驶时间的影响包括偏侧性和疼痛，但性别是混合的。讨论/结论. 研究结果与之前的系统评价一致，即在初次 TKA 或 THA 后重新驾驶汽车的情况变化很大，最常见于 4 周左右，但也可能在 2 至 8 周之间。虽然各种患者和临床因素会影响 TKA 或 THA 的恢复驾驶，但最常见的促成因素是疼痛和侧向性。这些研究的异质性阻止了一项荟萃分析，以确定在主要 TKA 或 THA 后返回对驾驶的贡献。无论如何，这项研究更新了之前的系统评价，并提供了对患者和临床因素的洞察，超越了回归驾驶汽车的广义时间框架。