Driving and emergency braking may be impaired after tibiotalar joint arthrodesis: conclusions after a case series.

Schwienbacher, Stefan; Aghayev, Emin; Hofmann, Ulf Krister; Jordan, Maurice; Marmotti, Antongiulio; Röder, Christoph; Ipach, Ingmar (2015). Driving and emergency braking may be impaired after tibiotalar joint arthrodesis: conclusions after a case series. International orthopaedics, 39(7), pp. 1335-1341. Springer 10.1007/s00264-015-2789-4

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PURPOSE To assess whether reaction time (RT) and movement time (MT), as the two components of the total brake response time (TBRT) and brake force (BF) are different in patients with a foot joint arthrodesis in comparison to controls. METHODS The study was a comparative case series in a driving simulator under realistic driving conditions. Mobile patients without a walker, ≥6 months after surgery who were driving a car and had no neurological co-morbidity, knee or hip joint prosthesis were included in the study. The selection criteria resulted in 12 patients with right tibiotalar joint arthrodesis (TTJA) and 12 patients with another right foot joint arthrodesis (OFJA), who were compared to 17 individuals without any ankle-joint pathology. For TBRT, an empirical safe driving threshold of 700 ms was used. The outcome measures were RT, MT, TBRT, BF and McGuire score. RESULTS MT (p = 0.034) and TBRT (p = 0.026) were longer in TTJA patients in comparison with the controls. Also, more patients with TTJA than patients with OFJA and controls exceeded the safe driving threshold (p = 0.028). The outcomes in OFJA patients and in controls were comparable. The McGuire score was similar between the TTJA and OFJA patients (p = 0.26). CONCLUSIONS Significantly slower MT and TBRT, and significantly more patients exceeding the safe driving threshold, were observed after a tibiotalar-joint arthrodesis in comparison to the controls. Patients with OFJAs were not significantly different from the controls. Driving and emergency braking may be impaired after tibiotalar-joint arthrodesis.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Evaluative Research into Orthopaedic Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Schwienbacher, Stefan; Aghayev, Emin and Röder, Christoph


600 Technology > 610 Medicine & health








Doris Kopp Heim

Date Deposited:

03 May 2016 12:52

Last Modified:

17 May 2016 14:01

Publisher DOI:


PubMed ID:


Additional Information:

Schwienbacher & Aghayev contributed equally to this work.





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