Hip surgery

Doctor when can I drive? A systematic review and meta-analysis of brake reaction time in patients returning to driving after hip arthroscopy for femoroacetabular impingement (FAI) (2025)

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Type of publication:

Journal article

Author(s):

*Patel, Ravi; Sokhal, Balamrit Singh; Fenton, Carl; Omonbude, Daniel; Banerjee, Robin; Nandra, Rajpal.

Citation:

Hip International, 2025 Feb 24.[epub ahead of print]

Abstract:

BACKGROUND: A common question from patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) is when they may return to driving.

PURPOSE: We aimed to perform a formal systematic review and meta-analysis to address this issue.

METHODS: A systematic review and meta-analysis followed PRISMA guidelines. Databases searched included OVID, EMBASE, and COCHRANE through July 2024 for articles with keywords and MeSH terms like "Hip arthroscopy," "Femoroacetabular Impingement," "total brake response time," and "reaction time" related to driving. Titles and full articles were reviewed for quality and relevance. Statistical analysis was done using Review Manager Version 5.4.A total of 39 articles were reviewed, with 5 meeting inclusion criteria. All selected articles used brake reaction time (BRT) as an outcome measure. A meta-analysis compared pre- and postoperative BRT values. Data were analysed for the right and left hips combined, followed by a subgroup analysis by laterality. BRT values were divided into preoperative and 2, 4, 6, and 8 weeks postoperative periods.

RESULTS: The studies assessed 160 patients, with 142 undergoing hip arthroscopy for FAI. The mean age was 32.75 +/- 9.4 years, with a male-to-female ratio of 73:69. The right hip was affected in 68% of
patients. Preoperative BRT ranged from 566 to 1960 milliseconds, while postoperative BRT ranged from 567 to 1860 milliseconds between week 2 and week 12.

CONCLUSIONS: BRTs returned to baseline or control values and continued to improve 4 weeks post-surgery for FAI. It is safe to recommend a return to driving at 4 weeks after hip arthroscopy for FAI.

Intraoperative Infiltration of Local Anaesthetic with Adrenaline In Sliding Hip Screw Surgery: Does It Reduce the Need for Transfusion? A Comparison of Practice Over Two Hospital Sites (2019)

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Type of publication:
Conference abstract

Author(s):
*T. Banks, *P. Jayawardena, *D. Ford

Citation:
British Journal of Surgery, Sep 2019; vol. 106, S6, p. 108

Abstract:
Aim: Post-operative blood transfusion is frequently required in patients undergoing Sliding Hip Screw (SHS) surgery. This is associated with transfusion related complications, increased cost and length of stay in hospital. We compared practice between two hospitals; pre-incision infiltration of local anaesthetic with adrenaline (LAAd) versus LA without adrenaline prior to wound closure, to evaluate if there was a difference in postoperative haemoglobin drop and the need for postoperative transfusion following SHS surgery.
Method: A retrospective service evaluation was performed using National Hip Fracture Database (NHFD) data in a cohort of 248 patients who underwent SHS surgery between 2017 and 2018; 110 patients had LAAd. Pre and post-operative haemoglobin, postoperative transfusion and local infiltration was recorded from the trust online patient databases. Relationships between groups was determined using z-testing on Excel.
Results: There was no significant difference in postoperative haemoglobin drop between the two cohorts (p=0.119). 32.7% of patients who had LAAd received blood transfusion in contrast with 20.3% without adrenaline.
Conclusion: Whilst surgeons using LAAd may report less bleeding from skin edges and vastus lataralis intra-operatively, and optimised regional anaesthesia, there was no significant difference in haemoglobin drop between the two cohorts. A difference in threshold for transfusion was identified between the
two hospitals.

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