When can you drive again after a hip or knee replacement?

“When can I drive again?” It’s one of the first questions people ask after a hip or knee replacement, often before they ask about stairs or getting back to work. And it makes sense. For many people, driving is independence: getting to physio appointments, the shops, family, work.

The honest answer is that there is no single date that fits everyone. But the research does give us a fairly consistent picture of when most people’s braking ability recovers, and that’s a far better starting point than the “six weeks, because that’s what we’ve always said” advice many patients still hear.

In this post, I’ll walk through what the evidence says, where it’s strong, where it’s thin, and what that means in practice for both patients and the physios guiding them.

How do researchers decide if someone is “ready” to drive?

Most studies use a driving simulator and measure total brake response time (TBRT): how long it takes from seeing a stop signal to pressing the brake pedal. It has two parts:

• Reaction time: the time to notice the signal and start moving (mostly brain and nerves).
• Movement time: the time to lift the foot off the accelerator and get it onto the brake (mostly the leg itself).

The usual approach is simple. Measure each patient before surgery, then again at 1, 2, 4 or 6 weeks after. Once braking is back to their own pre-op level, they are considered no less safe than they were before the operation.

One point worth knowing: before surgery, many people with hip or knee osteoarthritis already brake more slowly than healthy people of the same age, because of pain and stiffness. So “back to baseline” means back to their starting point, not necessarily to perfect.

The key study: 2 weeks for hips, 4 weeks for knees

The paper that prompted this post is a meta-analysis by van der Velden and colleagues (2017) in The Bone & Joint Journal. They searched nine databases and pooled 19 studies on braking after elective hip (THA) and knee (TKA) replacement for osteoarthritis. Most studies (12 of 19) were judged at low risk of bias.

Their headline findings, for right-sided surgery (the braking leg):

• Hip replacement: braking time was back to pre-op level by 2 weeks. The mean difference from baseline was a 25.5 ms improvement (95% CI −32.0 to 83.1).
• Knee replacement: braking time was back to pre-op level by 4 weeks. The mean difference was an 18.2 ms improvement (95% CI −6.1 to 42.5).

In plain terms, at those time points people braked about as fast as they did before surgery. Both confidence intervals cross zero, so we can’t say they were faster, only that they were no longer measurably slower.

The authors were careful to add that these figures are a guide and advice should be individualised. That caveat matters, and we’ll come back to it.

What do other studies say?

The 2017 paper isn’t the only one. Several reviews and newer trials have looked at the same question, and the picture is broadly consistent: somewhere between 2 and 6 weeks, depending on the joint, the side, and how strict you are about “recovered”.

Study	Joint	What they found
Patel et al., 2023 (Hip Int) — systematic review & meta-analysis	Hip	Braking back to baseline at 6 weeks. Recommended return across studies averaged 4.5 weeks; most of 960 patients self-reported driving again within about 6 weeks.
Bäcker et al., 2022 (Hip Int) — prospective, 25 right THAs	Hip	Brake force down and reaction slower for at least 2 weeks; no significant difference from pre-op by 4 weeks.
Giannoudis et al., 2021 (The Knee) — meta-analysis, 12 studies, 368 patients	Knee	Movement time slower at 2 and 4 weeks, back to normal by 6 weeks. Total braking time improved beyond baseline by 3 months.
Hartman et al., 2018 (J Arthroplasty)— systematic review, 9 studies, 330 patients	Knee	Braking normalised by 2 weeks after left and 4 weeks after right TKA.
Marques et al. (systematic review) — 10 studies	Knee	Mean return to baseline 44 days after right and 20 days after left TKA, with wide CIs. Suggested waiting at least 6 weeks (right) and 3 weeks (left).
Right TKR simulator study, 2021 (KSSTA) — prospective, 30 right TKRs	Knee	Patients’ baseline levels and their own driving confidence only returned at 6 weeks.

Three patterns stand out:

1. Knees take longer than hips. Probably because the quadriceps is directly affected by knee surgery, and it’s the muscle you rely on to move your foot quickly onto the pedal.
2. The right side matters most. In an automatic car, the left leg isn’t used to brake, so left-sided surgery has much less effect on braking. Manual cars are different, as the left leg works the clutch.
3. It’s the movement, not the brain. Giannoudis and colleagues found it’s the movement part of braking that slows down after knee surgery, not the reaction part. That fits with what physios see: a sore, weak, stiff leg rather than slower thinking.

Braking time isn’t the whole story

Here’s the limitation every one of these studies shares: a simulator measures one thing, an emergency stop, in a quiet lab. Real driving asks for more. A few other factors deserve as much attention as the numbers above.

Brake force, not just speed. Pressing the pedal quickly is one thing; pressing it hard enough is another. Bäcker and colleagues found braking force was clearly reduced straight after hip surgery. In another German study of a muscle-sparing hip approach, brake force was still below pre-op levels at 4 weeks, even though braking time had recovered.

Painkillers. Strong painkillers, especially opioids, can cause drowsiness and slow thinking. Most simulator studies don’t separate the effect of the operation from the effect of the medication. If you’re still on strong painkillers, that alone may be a reason not to drive, whatever the week number. In the UK it’s also an offence to drive if your driving is impaired by any drug, prescribed or not.

Getting in and out of the car. You need enough hip and knee bend to get in safely, sit comfortably for the journey, and get out again. NHS advice, as cited by Nouri and colleagues, is framed around exactly this: drive when you can bend your knee enough and control the car properly.

Confidence. In the 2021 right knee simulator study, patients’ own sense of being able to drive took 6 weeks to come back. Someone who feels nervous at the wheel isn’t ready, even if their reaction time says otherwise.

Legal and insurance responsibility. A 2023 review of regulations and insurance policies found that licensing bodies don’t set a fixed waiting time after hip or knee replacement; they leave it to the treating doctor, and insurers mostly do the same. In the UK, you only need to tell the DVLA if you still can’t drive 3 months after surgery. But it’s wise to check with your insurer and healthcare provider.

So, what does this mean in practice?

There is no single safe date, and this blog can’t tell you when you are ready to drive. The studies above describe averages from small groups tested in simulators, and individual recovery varies a lot. The decision is best made with your surgeon or physiotherapist, who know your operation and how your recovery is going.

For patients: here are some questions worth talking through with your healthcare team:

• Am I still taking strong painkillers, and could they affect my driving?
• Can I get in and out of the car safely and comfortably?
• Could I make an emergency stop, pressing hard, without pain or weakness holding me back?
• Do I feel confident behind the wheel?
• Does the side of my surgery, or whether my car is manual or automatic, make a difference for me?
• Have I checked what my insurer needs to know?

If you have any doubts or questions, please speak to your surgeon, GP or physiotherapist before you drive.

For physios: the evidence suggests that much of what slows braking after surgery is what we already assess: quadriceps strength, knee flexion range, pain, walking ability and medication use. One small study found step counts correlated moderately to highly with braking time after knee replacement, though this needs confirming in larger samples.

Rather than quoting a set number of weeks, it may help to raise driving early in rehab, explain that published timeframes are group averages with wide variation, and document the conversation. Final advice on returning to driving should follow local protocols and involve the surgical team and the patient.

Want to read more?

The short version: braking recovers faster than the old “six weeks for everyone” rule suggests, especially after hips and left-sided surgery. But readiness is about more than one number, and the decision should be individual.

If you’d like to dig into the evidence yourself, these are good places to start:

1. van der Velden CA, Tolk JJ, Janssen RPA, Reijman M. When is it safe to resume driving after total hip and total knee arthroplasty? A meta-analysis of literature on post-operative brake reaction times. Bone Joint J. 2017;99-B(5):566–76.
2. Patel PV, Giannoudis VP, Palma S, et al. Doctor when can I drive? A systematic review and meta-analysis of return to driving after total hip arthroplasty. Hip Int. 2023;33(1):17–27. (Open access)
3. Giannoudis V, Guy S, Romano R, et al. Doctor when can I drive? Braking response after knee arthroplasty: a systematic review & meta-analysis of brake reaction time. Knee. 2021;30:214–40.
4. Hartman J, Thornley P, Oreskovich S, et al. Braking time following total knee arthroplasty: a systematic review. J Arthroplasty. 2018;33(1):284–90.
5. Marques CJ, et al. What is the evidence on which physicians can rely to advise patients when they may resume driving after TKA? A systematic literature review. (Open access)
6. Bäcker HC, Krüger D, Spies S, et al. Effect of total hip arthroplasty on brake reaction time and braking force. Hip Int. 2022;32(1).
7. Reaction time and brake pedal force after total knee replacement: timeframe for return to car driving. Knee Surg Sports Traumatol Arthrosc. 2021;29(10):3213–20.
8. Liebensteiner MC, et al. Brake response time before and after total knee arthroplasty: a prospective cohort study. BMC Musculoskelet Disord. 2010;11:267. (Open access)
9. Timeframe for return to driving for patients with minimally invasive knee arthroplasty is associated with knee performance on functional tests. BMC Musculoskelet Disord. 2014;15.
10. Licensed and liable: insurance, road regulations, and driving after hip and knee arthroplasty surgery. J Arthroplasty.2023;38(4):644–48.
11. Nouri F, Coole C, Baker P, Drummond A. Return to driving after total hip and knee arthroplasty: the perspective of employed patients. Disabil Rehabil. 2022;44(25):7811–17.

Practical guidance (UK): GOV.UK: Surgery and driving

This post is for general information and isn’t a substitute for advice from your surgeon or physiotherapist.