May 04, 2014
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Driving ability hampered by dominant arm immobilization

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HOLLYWOOD, Fla. — Driving ability was more profoundly impaired in patients who undergo surgery on their dominant driving arm than on their non-dominant arm, according to a presenter here at the Arthroscopy Association of North America Annual Meeting.

“We also recommend against driving for a minimum of 6 weeks after arthroscopic rotator cuff repair or glenoid labral repair surgery, especially if the dominant driving arm is the extremity involved,” Laith M. Jazrawi, MD, said. “This data has implications for future enactment of policy.”

Researchers used a driving simulator with to analyze patients who had their dominant driving arm in a sling. Patients in the study had a mean age of 44 years and a mean of 25 years driving experience, and the cohort was split between 10 rotator cuff repairs and 8 labral repairs. Study was powered by total number of collisions, center line crossings and road edge excursions at preoperative baseline, 6 weeks and 12 weeks postoperatively. The study compared the patients to simulator results of a healthy cohort with both arms available who had first the dominant then non-dominant arm placed in a sling. The researchers also analyzed VAS and Shoulder Pain and Disability Index (SPADI) values.

Collisions increased from 2.05 preoperatively to 3.72 at the 6-week follow-up then decreased to 1.72 at final follow-up. Average VAS scores for pain were 4.78, 6.06, and 2.83 out of 10, and mean SPADI scores were 49.4, 62.7, and 30.4 for all patients at the preoperative, 6-week and 12-week follow-ups. Patients who had surgery on the dominant driving arm had an increase of 2.6 collisions at 6 weeks after surgery compared to a 0.6-increase on patients with surgery on the non-dominant arm. Patients in the sling cohort had 3.65 collisions vs. 1.71 collisions in the non-sling group.

“Although shoulder arthroscopic repairs may not adversely standard driving conditions, they certainly limited the ability to perform evasive maneuvers under hazardous conditions,” Jazrawi said. – by Christian Ingram

Reference:

Jazrawi LM. Paper #SS-21. Presented at: Arthroscopy Association of North America Annual Meeting; May 1-3, 2014; Hollywood, Fla.

Disclosure: Jazrawi has no relevant financial disclosures.