Patient satisfaction with inpatient versus outpatient reconstruction of the anterior cruciate ligament: a randomized clinical trial.
OBJECTIVE
To compare satisfaction levels after reconstruction of the anterior cruciate ligament (ACL) between inpatients and outpatients by means of a valid and comprehensive outcome tool.


METHODS
Fifty patients examined at a tertiary clinic who met the study's inclusion criteria (15-50 yr old, no previous ACL reconstruction, > 6 h after injury, living < 1 h from hospital, assigned a caregiver for outpatient management within 48 h of injury, no serious health condition, no known hypersensitivity to ASA/NSAIDs, bleeding disorder or gastric ulcer, ability to cope at home after operation) were recruited and randomized into either the inpatient or outpatient groups. Inpatients stayed overnight in hospital after their ACL reconstruction and were discharged home the next day. Outpatients were discharged home on the day of the procedure. All patients attended a preoperative educational session and were required to meet the same discharge criteria (able to bear weight using crutches and to void, to be reasonably pain free, no nausea or vomiting, no excess bleeding or drainage, be alert, be given take-home medications and be in the company of a caregiver). Standardized anesthetic and postoperative analgesic protocols were used. One week after ACL reconstruction, patient satisfaction was quantified with a previously validated visual analogue questionnaire (maximum score of 100).


RESULTS
We collected data on 21 inpatients and 19 outpatients. The mean overall-satisfaction score of the outpatient group was higher than that of the inpatient group (85.1 v. 78.2, p = 0.015). Between-group differences in postoperative pain, nausea, rate of readmission and complications were not significant.


CONCLUSIONS
As determined by a comprehensive, population-specific, validated outcome, patient satisfaction is higher when ACL reconstruction is done on an outpatient basis.
Krywulak
Steven A
SA
Division of Orthopedic Surgery, University of Calgary Sport Medicine Centre, Alta.
Mohtadi
Nicholas G H
NG
Russell
Margaret L
ML
Sasyniuk
Treny M
TM
D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures; D016058:Analgesia, Patient-Controlled; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D006760:Hospitalization; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction