BACKGROUND: As arthroplasty techniques become more advanced, patients recover more rapidly. Is this same trend observed with patients' ability to drive after hip and knee replacement? The purpose of this study was to evaluate the impact of various factors on patients' ability to drive within 4 weeks after primary hip or knee arthroplasty to better counsel patients on their return to driving postoperatively. MATERIALS AND METHODS: This retrospective cohort study investigated 1146 patients who underwent primary joint arthroplasty. These patients were surveyed 3 to 4 weeks after surgery, and 851 patients were included in the analysis. Univariate and multivariate analyses were performed to determine which factors were associated with return to driving. RESULTS: Among the patients, 47.0% (n=382) returned to driving within 4 weeks of their procedure, with a mean postoperative time of 16.0±6.3 days. Factors significantly correlated with an early return to driving based on univariate analysis included younger age at surgery, lower body mass index, male sex, prior daily driving, same-day discharge, higher scores on patient-reported outcome measures, left-sided procedure, unicompartmental knee arthroplasty (UKA), no walking aids, and no use of narcotic pain medication. Multivariate Cox regression analysis revealed that male sex (hazard ratio [HR], 2.19), same-day discharge (HR, 1.86), prior daily driving (HR, 1.81), left-sided surgery (HR, 1.62), and type of procedure (UKA: HR, 1.65
total hip arthroplasty by the direct anterior approach: HR, 1.50) were associated with early return to driving. CONCLUSION: Many patient, surgical, and rehabilitation factors can impact the ability of primary arthroplasty patients to return to driving within 4 weeks of surgery. This large cohort incorporating current surgical techniques can support surgeons to better counsel patients on their expected return to driving. [