French prospective multicenter comparative assessment of ambulatory surgery feasibility in anterior cruciate ligament reconstruction.

INTRODUCTION: The main objective of this multicenter study was to assess the feasibility of ambulatory surgery in France in anterior cruciate ligament (ACL) reconstructions for any technique or graft used (hamstring, patellar tendon, fascia lata). We hypothesized that a dedicated organization would guarantee the patient's safety.

PATIENTS AND METHODS: A multicenter, non-randomized, prospective, comparative study, conducted within the SFA symposium was conducted between January 2014 and March 2015, included all the patients operated on for arthroscopic ACL reconstruction using different surgical techniques. The outpatient group (OP) included patients eligible for day surgery who provided informed consent; the conventional hospitalization group (CH) comprised patients declined for outpatient surgery for organizational reasons. The main outcome was failure of the admission mode defined by hospitalization of a patient undergoing outpatient surgery or rehospitalization within the 1st week after discharge. The secondary outcomes were assessment of pain and postoperative complications. A total of 1076 patients were studied with 680 in the OP group and 396 in the CH group. The mean age was 30years±9years. In the CH group, the mean hospital stay was 2.7±0.8days.

RESULTS: Twenty-three OP patients were hospitalized or rehospitalized (3.4%). Thirty-six (5.2%) early postoperative complications were noted in the OP group and 17 (4.3%) in the CH group (non-significant difference). Mean postoperative pain on D0-D4 and satisfaction were comparable between the two groups.

CONCLUSION: This prospective multicenter study observed no serious incidents. In a selected population, the risks are comparable to those of conventional hospitalization. Outpatient ACL surgery is therefore feasible in France in 2016.

LEVEL OF PROOF: III: case-control study.