Dr. Jordan Buchko  MD, FRCSC          

  Orthopaedic Surgeon - Arthroscopy & Sports Medicine 

Driving after Orthopaedic Surgery or Musculoskeletal Injury


Driving is a privilege, it is not a right. It is very important that you are safe when you return to driving after your surgery or injury. The safety of yourself, your loved ones, and everyone in our community depends upon it.


Orthopaedic surgery and musculoskeletal injuries have several implications and physical effects that may preclude you from safely operating a vehicle. These include the effects of pain, anesthetic, analgesics (i.e. painkillers), splints/casts/braces/immobilizers, and physical impairment from the affected body part. Thus, Dr. Buchko advises you to follow these recommendations:



  • Do not drive for at least 24 hours after receiving a general or spinal anesthetic, to allow the effects of the anesthetic to wear off. If you had a minor procedure, are not taking any narcotics, have minimal pain, and your musculoskeletal condition does not affect the ability to operate a vehicle safely, then you may resume driving after 24 hours of your procedure.


  • Do not drive if you are currently taking narcotic analgesics (ex. hydromorphone, morphine, oxycodone, Tramacet/tramadol, Tylenol#3/codeine). You should be off all narcotic medications before you resume driving.


  • Do not drive if you are having significant pain that could interfere with your ability to concentrate on driving.


  • Do not drive if you have a splint, cast, sling, or immobilizer on either upper extremity (ex. after shoulder surgery). *

  • Do not drive if you have a splint, cast, orthopaedic boot, or knee brace/immobilizer (holding knee straight) on your right lower extremity (if driving a vehicle with an automatic transmission) or on either lower extremity (if driving a vehicle with a manual transmission). *

  • Do not drive if you are on crutches and are not able to fully weight-bear (either due to pain or to Dr. Buchko’s orders) on your right lower extremity (if driving a vehicle with an automatic transmission) or on either lower extremity (if driving a vehicle with a manual transmission).

Note: after removal of an immobilization device, there may be a brief recovery period wherein you still should not drive (such as a few weeks) if there is pain, stiffness/incomplete range of motion, or inability to completely weight-bear.


*The Canadian Medical Association Driver’s Guide states: Safe driving requires both hands to be firmly on the steering wheel, except as required to operate other controls, and the ability to solidly grip the manual gear shift, when and where applicable. It is also requires the ability to use the lower right leg to operate the accelerator pedal appropriately and to operate the brake pedal  with sufficient speed and force to brake in an emergency, and the lower left leg to the same degree to operate the clutch, in the case of a vehicle with manual transmission.


Thus, if you: 1) are not able to fully grip the wheel with both hands due to a cast/immobilizer/etc. or; 2) not able to put full weight on your lower extremity that you drive with, or; 3) have a cast/boot/etc. on your lower extremity that you normally drive with, then your ability to operate a vehicle safely may be impaired, and you should not drive. Please note: you cannot substitute your left foot for your right foot if you drive an automatic transmission and your right foot/lower extremity is affected (i.e. you cannot drive using your left foot if your right leg is in a cast).


Below are some guidelines as to when you can likely safely resume driving after your Orthopaedic surgery or musculoskeletal injury. Please note however these are guidelines only, and Dr. Buchko encourages you to discuss with him. Alternatively, you may also contact the SGI Medical Review Unit if you have any questions about your ability to drive.

Estimated minimum timelines for return to drive:


  • Shoulder arthroscopy (left or right) – debridement/clean-up: 2-4 weeks
  • Shoulder arthroscopy (left or right) – labral repair: 4-6 weeks (must be out of sling)
  • Shoulder arthroscopy (left or right) – rotator cuff repair: 6 weeks
  • Right hip arthroscopy: 4 weeks
  • ^Left hip arthroscopy: 2-4 weeks (must limit hip flexion to less than 90 degrees)
  • Right knee ligament reconstruction (ex. ACL, MPFL, etc.): 6 weeks
  • ^Left knee ligament reconstruction (ex. ACL, MPFL, etc.): 2 weeks
  • Right knee arthroscopy: 4 weeks
  • ^Left knee arthroscopy: 1 week
  • Right ankle fracture surgery: 9 weeks
  • ^Left ankle fracture surgery: 2 weeks
  • Right ankle fracture treated non-operatively: 2 weeks after cast removal (~8 weeks)
  • ^Left ankle fracture treated non-operatively: 2 weeks
  • Right lower extremity long bone fracture surgery (tibia or femur): 9-12 weeks
  • ^ Left lower extremity long bone fracture surgery (tibia or femur): 2 weeks
  • Right lower extremity periarticular fracture surgery (femur or tibia): 18 weeks
  • ^ Left lower extremity periarticular fracture surgery (femur or tibia): 2 weeks
  • Right total or partial hip replacement: 4-6 weeks
  • ^Left total or partial hip replacement: 2 weeks (as long as can maintain hip precautions)
  • Right total or partial knee replacement: 4-8 weeks
  • ^Left total or partial knee replacement: 2 weeks

^ Assuming automatic transmission. If standard transmission, please refer to right-sided recommendations.

Please note these are the minimum timeframes for return to drive. It may take you a few weeks longer than this if you have residual pain, stiffness, limp, etc. These guidelines are based on a review of the literature, and studies assessing ability to drive (particularly for upper extremity conditions) and braking time (particularly for lower extremity conditions).


***IMPORTANT*** Patients must self-report to the SGI Medical Review Unit any change in medical condition that may affect ability to drive, even for conditions that are temporary or transient (such as a cast or a recovery period following surgery). This is stated in the Saskatchewan Driver’s Handbook (Section 2.6 - Medical Requirements)
.  If you are involved in an accident that is related to your medical condition, you may not have insurance coverage and your claim may be denied. Thus Dr. Buchko strongly recommends you self-report your medical condition to the SGI Medical Review Unit by filling out the Supplementary Medical Application Form.  Please note it is the driver’s responsibility to self-report these temporary conditions to the SGI Medical Review Unit, not Dr. Buchko’s.


References
1. Is Your Patient Fit To Drive? Medical/Legal Implications Course 2016.

2. Marecek GS & Schafer MF. Driving After Orthopaedic Surgery. J Am Acad Orthop Surg 2013;21:696-706.

3. CMA Driver’s Guide – 8th Edition (2012). Section 21 – Musculoskeletal Disabilities

4. Saskatchewan Driver’s Handbook 2016. Section 2.6 – Medical Requirements.







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