Abstract
Introduction/aims
Anterior cruciate ligament (ACL) reconstruction is now routinely performed arthroscopically. However, there are only a few centres in the UK which offer this procedure as a day case. We aimed to assess the clinical outcomes of day case ACL reconstruction using a tourniquet-less pump regulated procedure.
Material/methods
A retrospective analysis of day case ACL reconstructions by a single surgeon between January 2003 and December 2010 was undertaken. All reconstructions were performed without a tourniquet, instead, haemostasis was achieved using saline – epinephrine irrigation. Outcomes were measured using Lysholm knee scores, Mohtadi index and pain scores.
Results
374 ACL reconstructions were performed on 331 patients (288 unilateral, 43 bilateral) during the study period. The average age was 31 years (range 15–58 years). All patients were followed up at regular intervals for 12 months. Lysholm knee scores improved from an average of 25 to 90. Mohtadi index scores also showed significant improvement; from an average of 22 to 90 post-operatively. All patients were pain free by 6 weeks post ACL reconstruction based on the VAP score. Complications occurred in 3% (n=11) of patients, these included DVT, wound infection and haemoarthorosis. Metal work failure occurred in 2 patients, both of whom had the EZLoc™ fixation system.
Conclusions
Our experience shows that day case ACL reconstructions without the use of a tourniquet are cost effective, safe and the patients' preferred choice. Perhaps, therefore, it is time to include ACL reconstructions in the British Association of Day Case Surgery “basket” of day case procedures?
