title: Pain experience and functional outcome of inpatient versus outpatient anterior cruciate ligament reconstruction, an equivalence randomized controlled trial with 12 months follow-up.
abstract: BACKGROUND
  Arthroscopic reconstruction of the anterior cruciate ligament (ACL) has traditionally been performed in an inpatient setting. Outpatient treatment may offer the advantages of cost reduction and higher patient satisfaction.
  
  
  OBJECTIVE
  We investigated whether ACL reconstruction in an outpatient setting is equally safe as in an inpatient setting and whether comparable functional outcomes can be achieved. We hypothesized that the outcomes of outpatient ACL reconstruction result in similar outcomes as inpatient ACL reconstruction.
  
  
  METHODS
  A prospective randomized controlled trial was conducted at one centre.
  
  
  METHODS
  Forty-six patients were randomized to outpatient treatment or a 2-day admission after ACL reconstruction. The functional outcome was evaluated with the Lysholm, Tegner and International Knee Documentation Committee scores. Safety of the procedures was judged according to pain experience and readmission rate. The duration of follow-up was 1 year after ACL reconstruction. The patients were provided with a simple postoperative analgesic protocol. The linear mixed effect model for repeated measures was used for testing the differences between the study groups.
  
  
  RESULTS
  No significant differences were found between the study groups in all the outcome measures. No readmissions were recorded related to pain. One complication was recorded in the outpatient group versus three in the inpatient group.
  
  
  CONCLUSIONS
  This study indicates that outpatient care after ACL reconstruction yields comparable functional results and postoperative pain experience as inpatient care and is a safe option. A simple analgesic protocol provides adequate pain relief during the postoperative phase.
  
  
  METHODS
  I.
authors: Department of Orthopaedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: kars.valkering@gmail.com.
authors: K P
authors: KP
authors: Valkering
authors: Department of Orthopaedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors: C J A
authors: CJ
authors: van Bergen
authors: Department of Orthopaedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors: G A
authors: GA
authors: Buijze
authors: Department of Trauma Surgery, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands.
authors: P H A F
authors: PH
authors: Nagel
authors: Department of Trauma Surgery, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands.
authors: W E
authors: WE
authors: Tuinebreijer
authors: Department of Trauma Surgery, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands.
authors: R S
authors: RS
authors: Breederveld
mesh_terms: D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D016118:Anterior Cruciate Ligament / Q000502:physiology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anterior cruciate ligament; Inpatient; Outcome; Outpatient; Rehabilitation