title: Anterior cruciate ligament reconstruction as an outpatient procedure.
abstract: During a 27-month period, 222 patients with 227 anterior cruciate ligament-deficient knees underwent arthroscopically assisted reconstructions as outpatient procedures. Bone-tendon-bone autografts were used for 169 of these reconstructions; the other 58 were done with bone-tendon-bone allografts. Additional procedures were performed on 180 of the patients. The interval from injury to reconstruction averaged 29 months. The protocol developed at our clinic employs a general anesthetic administered with the intent of same-day discharge, infiltration of the skin and joint with bupivacaine, a cold compressive dressing, and the use of both ketorolac tromethamine and a Schedule III narcotic (acetaminophen with codeine or with propoxyphene) for postoperative pain control. At an average followup of 10 months, no readmissions in the immediate postoperative period had been required and no short- or long-term postoperative complications could be attributed to the protocol. This safe and effective technique offers the patient the advantage of anterior cruciate ligament reconstruction as a same-day procedure and allows the surgeon to implement its use in any outpatient setting without additional discharge planning.
authors.affiliation: Minneapolis Sports Medicine Center, MN 55454, USA.
authors.forename: G S
authors.initials: GS
authors.lastname: Tierney
authors.forename: R W
authors.initials: RW
authors.lastname: Wright
authors.forename: J P
authors.initials: JP
authors.lastname: Smith
authors.forename: D A
authors.initials: DA
authors.lastname: Fischer
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage; D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D001458:Bandages; D002045:Bupivacaine / Q000008:administration & dosage; D002648:Child; D003061:Codeine / Q000008:administration & dosage; D017679:Cryotherapy; D011431:Dextropropoxyphene / Q000008:administration & dosage; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D007279:Injections, Subcutaneous; D020911:Ketorolac Tromethamine; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D017847:Patellar Ligament / Q000637:transplantation; D010359:Patient Readmission; D011183:Postoperative Complications; D014046:Tolmetin / Q000008:administration & dosage / Q000031:analogs & derivatives; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014325:Tromethamine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D014325:Tromethamine; D000082:Acetaminophen; D020911:Ketorolac Tromethamine; D014046:Tolmetin; D011431:Dextropropoxyphene; D003061:Codeine; D002045:Bupivacaine