When Can I Drive After Orthopedic Surgery?
⌚️ read time: 7.9 minutes
Disclaimer: Before we start, I have an extra special disclaimer today. This is in no way a guide to the question of when to drive after surgery. This is simply an education on the complexity of the topic, using current research to explain the issue. As with all articles on this site, this is not medical advice, and the use of materials on this site (or linked from this site) is at the user’s own risk.
Here's something that might surprise you. Despite how common orthopedic surgeries are, and how important driving is to most people's daily lives, there are virtually no official guidelines about when it's safe to get back behind the wheel.
(Want a real deep dive here? I wrote a long paper on this topic that was published in the medical literature back in 2019. Warning, it’s a bit dense…link here).
In fact, when I talk to patients about this, they're often shocked to learn that their surgeon, their insurance company, and even their state's Department of Motor Vehicles are all basically shrugging their shoulders on this one.
It's a wild west out there when it comes to driving after surgery.
And yet, this is one of the most common questions I get in my practice. Perhaps more importantly, we know many of you are just going to drive anyway.
One study found that 35% of patients were back driving while still on narcotics after surgery. Even more concerning? About 19% of those patients admitted they felt unsafe doing so.
Let me say that again. They knew it wasn't safe, but they drove anyway. We need to talk about this.
What Makes Safe Driving... Safe?
First, we need to understand what we're actually measuring when we talk about safe driving. This is an important question any time we do research. What are we actually going to measure and how does that translate to the real world?
In the world of ‘safe driving research,’ most studies focus on the critical question of “How fast can you slam on the brakes in an emergency?”
Seems like a reasonable question to answer. It’s not the whole picture of safe driving, but it’s likely the most important bit.
Think about it. If you're wearing a cast or recovering from surgery, what really matters is whether you can stop your car fast enough to avoid an accident.
We call this your brake reaction time, and it's actually made up of two parts:
The time it takes your brain to recognize danger and decide to move your foot
The time it takes to physically move your foot from gas to brake
Studies have found that even small changes in this reaction time can mean the difference between stopping safely and a serious accident. At highway speeds, just half a second of delay means an extra 45 feet of car travel before you stop.
That's about three car lengths.
Scary.
When Does Your Body Get That Ability Back?
This is the all-important question. And where things get interesting (ahem, frustrating). Different surgeries affect your driving ability in very different ways.
And it's not always intuitive. Sometimes what seems like a "minor" surgery can affect your driving more than you'd expect.
Let’s go through the research we currently have on a few common procedures. This is not a guide to when to return to drive. These are simply examples from our literature to help you understand the complexity of this issue.
Knee Arthroscopy (tiny cameras in knee)
Four weeks. Even though it's "just a scope," the research pretty consistently shows your brake reaction time is notably slower for that first month.
And here's the kicker. About 30% of patients still haven't returned to their normal reaction times by that four-week mark.
Are you starting to see why this simple question of “When can I drive” makes me sigh each time I’m asked?
Total Knee Replacement
Somewhat surprisingly, brake reaction times after major knee surgery don’t lag far behind that of knee arthroscopy. Most people regain their brake reaction time around 4-5 weeks following right knee replacement (these are USA studies where the right leg is the one controlling the brake.
What if you had surgery on your left knee? If you drive an automatic, brake reaction time seems to come back on average about 2 weeks after surgery, even when it was done on your ‘non-driving’ leg.
But remember. That's assuming everything else has gone well with your recovery. And these numbers are just averages.
Ankle Surgery
While the variety of surgeries one could have on their ankle is wide, the majority of driving studies show ankle surgery takes much longer to recover from. Specifically, an average of 9 weeks before your reaction times are back to normal.
And please, don't try driving with a cast or boot on your right foot. Studies show your reaction time nearly doubles, not to mention the clunkiness and lack of coordination in a boot.
Just say no.
Upper Extremity Surgery
You thought things were murky until now? Try looking at the upper extremity research.
Are we talking above-elbow immobilization (eg, sling after shoulder surgery, long-arm cast)? Definitely not safe to drive.
Simple forearm cast? It’s not going to affect your brake time, but can you control the wheel in an emergency? We have very little evidence here. There’s not an ‘easy question’ to study relative to control of the wheel in the same way we can study brake reaction time.
What do we know? Studies do show we're terrible at judging our own impairment with arm injuries. Hands and arms are highly coordinated parts of our body (did you know control of the hand takes up about 25% of our brain’s motor control resources??), and even small alterations in their function can have outsized effects.
The "Clearance" Myth
Here's the next wrinkle in our story that will likely come as a shock. When you ask your surgeon to "clear" you for driving, you're actually asking them to do something they legally shouldn't do.
Why? Because they have no legal authority to do so. There is nothing in our 50 states’ various Motor Vehicle legal codes that relies on a doctor’s evaluation. So all this does is muddy the water relative to your safety and that of everyone else on the road too.
This is why many surgeons (myself included) won't actually "clear" you to drive. Instead, we'll tell you what the evidence shows and how we think about when you might be ready to test your ability to drive safely.
But ultimately, the decision - and the liability - rests with you. When accidents happen, these cases go to court and they center around your personal liability in deciding whether to get behind the wheel.
What Can Go Wrong?
Let me share a real scenario from the literature: A patient two weeks out from knee surgery feels great on their pain meds. They decide to drive to the grocery store "just this once." On the way, a child chases a ball into the street.
That extra half-second of reaction time? It matters. A lot.
Or consider this: You're wearing a shoulder sling and think you can manage with just one arm. Then someone cuts you off and you need to make a quick steering correction. Suddenly that "manageable" situation becomes dangerous for everyone on the road.
How Do You Know If You're Really Ready?
Beyond timing, here are some practical questions to consider as you recover from surgery:
Can you get in and out of the car comfortably?
Can you turn your body enough to check your blind spots?
Are you completely off narcotic pain medication (this one is not grey, it’s actually the law)?
Could you do an emergency stop if a child ran into the street?
Can you turn the steering wheel quickly if needed?
If you hesitated on any of those, consensus would say that you’re probably not ready. While most of the time we spend driving is ‘easy,’ this decision needs to be made considering worst-case scenarios.
The Reality Check
Let's be honest. In today's world, not being able to drive can feel like losing your independence. I've had patients tell me they'll lose their job if they can't drive. Others live alone and worry about getting groceries or making it to follow-up appointments.
These are real concerns.
But getting into an accident is something we absolutely cannot accept. Needless to say, it creates a whole new set of legal and injury problems…or worse.
The best thing you can do is plan ahead. Before your surgery, set up a support network. Line up friends and family to help with rides. Look into temporary transportation alternatives. Some communities even have volunteer driver programs for medical appointments.
It's far better to spend a few weeks figuring out rides than to risk your safety (or someone else's) on the road.
Takeaways:
Different surgeries require different recovery times for safe driving
You must be off narcotics and be able to perform emergency maneuvers before returning to driving
The final decision to drive is yours. Whether we like it or not, that also means the liability is yours if something goes wrong
This topic is highly frustrating for both patients and doctors alike. I know how painful it is to be stuck without the ability to drive.
But rushing back too soon also isn't worth the risk — to you or others on the road.
As always, if you found this helpful, please consider sharing it with someone planning surgery. And maybe offer them a ride while they recover.
