title: Postoperative discomfort after outpatient anterior cruciate ligament reconstruction: a prospective comparative study.
abstract: BACKGROUND
  The principal objective of the present study was to compare rates of postoperative discomfort after anterior cruciate ligament (ACL) reconstruction between inpatient (In) and outpatient (Out) management.
  
  
  METHODS
  A single-surgeon non-randomized prospective comparative study included patients undergoing primary surgery for isolated ACL tear by short hamstring graft in 2012-13. The Out group comprised patients eligible for and consenting to outpatient surgery and the In group, those not eligible or not consenting. The principal assessment criterion was onset of at least 1 symptom of postoperative discomfort (SPD): anxiety, nausea and vomiting, malaise, vertigo or stomach pain, between postoperative days 0 and 3. Secondary assessment criteria were difficulty in getting to sleep, getting up during the night, regular walking or going out, number of episodes of knee pain and waking because of pain. All criteria were assessed on-line by the patient.
  
  
  RESULTS
  One hundred and thirty-three patients filled out the questionnaire, 70 in the Out group and 63 in the In group; 42 females, 91 males; mean age, 30±9 years. Between D0 and D3, the proportion of patients with ≥l SPD was comparable between groups (Out 37% vs In 41%, P=0.62). Out-group patients had significantly less difficulty sleeping the first postoperative night (P=0.01), got up significantly more often during the first night after surgery (P<0.0001), more often walked regularly on day 1 (P=0.03), and were significantly less often woken by pain during the first night (P=0.003). Risk factors for SPD were female gender (OR=4.8±1.9) and postoperative complications (OR=3.8±2.5).
  
  
  CONCLUSIONS
  Patients undergoing ACL reconstruction on an outpatient basis did not show more symptoms of postoperative discomfort than those managed as conventional inpatients.
  
  
  METHODS
  IV; prospective comparative study.
authors: Clinique du sport Paris V, 36, boulevard Saint-Marcel, 75005 Paris, France; Institut de l'appareil locomoteur Nollet, 75017 Paris, France; Clinique Maussins-Nollet, 75019 Paris, France. Electronic address: docteurlefevre@sfr.fr.
authors: N
authors: N
authors: Lefevre
authors: Clinique du sport Paris V, 36, boulevard Saint-Marcel, 75005 Paris, France; Institut de l'appareil locomoteur Nollet, 75017 Paris, France.
authors: S
authors: S
authors: Klouche
authors: Clinique du sport Paris V, 36, boulevard Saint-Marcel, 75005 Paris, France.
authors: O
authors: O
authors: de Pamphilis
authors: Clinique Maussins-Nollet, 75019 Paris, France.
authors: C
authors: C
authors: Devaux
authors: Clinique du sport Paris V, 36, boulevard Saint-Marcel, 75005 Paris, France; Institut de l'appareil locomoteur Nollet, 75017 Paris, France; Clinique Maussins-Nollet, 75019 Paris, France.
authors: S
authors: S
authors: Herman
authors: Clinique du sport Paris V, 36, boulevard Saint-Marcel, 75005 Paris, France; Institut de l'appareil locomoteur Nollet, 75017 Paris, France; Clinique Maussins-Nollet, 75019 Paris, France.
authors: Y
authors: Y
authors: Bohu
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects*; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies
keywords: Anterior cruciate ligament reconstruction; Outpatient surgery; Symptoms of postoperative discomfort