Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Sports Medicine - Knee
Abstract number: 25055
PATIENT SATISFACTION FOLLOWING DAY-CASE ARTHROSCOPIC SINGLE
BUNDLE FOUR STRAND HAMSTRING ANTERIOR CRUCIATE LIGAMENT
RECONSTRUCTION
Robert KEEHAN 1 , Philip MCCANN 2 , G THOMAS 1 , Michael RADFORD 1
1 Weston General Hospital, Somerset (UNITED KINGDOM), 2 Gloucestershire Royal
Hospital, Gloucestershire (UNITED KINGDOM)
Purpose: We studied the feasibility of performing arthroscopic, double-bundle
anterior cruciate ligament (ACL) reconstruction as a day-case procedure by
assessing patient satisfaction and radiological outcome. Methods: A preliminary
analysis of patients undergoing primary ACL reconstruction demonstrated that with
injection of levo-bupivacaine into the knee and graft harvest sites, peak pain scores
occurred sufficiently early to allow day-case discharge. The subsequent 23
consecutive patients undergoing primary ACL reconstruction were then assessed.
Clinical data was collected by case-note analysis. Patient satisfaction was assessed
using a standard questionnaire and surgical technique by analysis of radiographic
tunnel positions. Results: The average age was 31.4 years. Male to female ratio was
20:3. 14 patients (61%) were discharged as day-cases. 9 patients (39%) had 1
overnight stay. Reasons for an overnight stay were specified as post anaesthetic
symptoms (4 patients), unsafe mobility (3 patients), patient concern (1 patient) and
delayed micturition (1 patient). Of the 14 patients discharged as day-cases 13 (93%)
stated that they were satisfied with their experience. 1 (7%) stated that he was not
satisfied because he felt weak and unwell post-operatively. All patients’ tunnel
positions were satisfactory. Patients were more likely to be discharged on the day of
surgery if booked as day-cases, and placed on a morning list. Patient satisfaction
may be improved by additional pre-operative education, and by adjustments to postoperative
analgesic and antiemetic medication. Conclusion: We conclude that daycase
arthroscopic double bundle ACL reconstruction is feasible in a district general
hospital, and is acceptable to most patients.
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