A COMPARISON OF OUTPATIENT AND INPATIENT ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION SURGERY

The feasibility of outpatient anterior cruciate ligament (ACL) surgery has not been reported in the literature. We evaluated outpatient ACL surgery by comparing outpatient versus inpatient pain control, narcoti c consumption, postoperative complications, recovery time, and cost an alysis. Thirty-seven ACL reconstructions were performed in 37 patients over a 16-month period. Twenty-five of the patients had surgery perfo rmed as outpatients and 12 as inpatients. One of the outpatients requi red hospitalization because of excessive nausea and vomiting and anoth er for urinary retention. Only 2 of the 25 outpatients (8%) believed t hat they should have been hospitalized for pain control. Based on a vi sual analog scale, pain severity, pain frequency, and pain relief were measured, and no statistically significant difference (P <.05) was no ted between the groups, although the data suggested that the inpatient s were slightly more comfortable. There were no differences in rehabil itation or in regaining full range of motion of the operated knee. Als o, the only postoperative complication in both groups occurred in an i npatient who developed arthrofibrosis. Cost analysis showed that outpa tient ACL reconstruction was cost effective. The average inpatient cos t was $9,220 (2.4 hospital days) compared with the average outpatient cost of $3,905. This reflected a savings of 58%. These results show th at outpatient ACL reconstruction surgery is possible in the appropriat e patient without harm to the patient and with a significant cost savi ngs.