Return to driving after arthroscopic shoulder surgery: A retrospective study exploring the influencing factors and medico-legal issues

Kieran Clark, Angus Hotchkiss, Emma Torrance, Lennard Funk

In Press

Background
Return to driving time after surgery is a common question asked pre-operatively by patients. Although general recommendations exist, the factors that influence return to driving time and the medico-legal implications specific to shoulder surgery are relatively unknown. Study aims were to compare actual return to driving times to the recommended times after shoulder surgery, explore factors influencing return to driving times and the legal implications of recommencing driving.

Methods
A retrospective study including 124 patients, 38 female, 86 male, who had undergone elective shoulder surgery over a one year period. Information regarding return to driving time, gender, age, occupation, car transmission type and reason for recommencing driving was analysed. Insurance companies and the Driving and Vehicle Licensing Agency (DVLA) were contacted to clarify the medico-legal stance.

Results
Mean return to driving time was significantly longer after arthroscopic decompression +/- acromioclavicular joint excision at 18.6 days (p= <0.0001) and significantly shorter after stabilization procedures 38.7 (p= 0.0142) than the recommended time. Males and drivers of automatic cars returned to driving sooner. Three of five major insurance companies stated that insurance was invalid if patients returned to driving before it was recommended. 63% of patients stated comfort as the main factor influencing the time they returned to driving.

Discussion
Patients should only return to driving after the time recommended by their clinician, when driving is comfortable and when they physically feel completely in control of the vehicle or insurance may be invalidated.

Keywords: Return to driving time; influencing factors; shoulder surgery; arthroscopic surgery;
medico-legal issues.