Aim: To assess patients’ progress early after ACL reconstruction and to identity factors favouring outpatient surgery.

Method: Eighty-three patients who had received a bone-patellar tendon-bone graft of whom 32 patients (38.5%) were treated as day-cases answered a telephone questionnaire. Information was gained on pain levels (scored from one to seven), medication received, complications and re-admission rates.

Results: On the night of discharge 28% of day-case patients suffered pain greater than level 4 but all stated that oral non-steroidal anti-inflammatory drugs and non-opiate analgesics were sufficient to control their pain. Over the first 2 weeks after operation outpatients experienced statistically higher pain levels than inpatients (P = 0.03). Most patients in the study experienced their peak pain levels on the first and second days after the surgery rather than on the night of the surgery. Eighty-one percent of outpatients had their surgery started before 9:30am compared with 29% of inpatients. Drowsiness (n = 18), nausea (n = 11), unsuitable home conditions (n = 9) and pain (n = 7) were the most common reasons for patients choosing in-patient treatment. Six patients (five in-patients and one out-patient) were treated for superficial infections including the one patient who required re-admission (for intravenous anti-biotics). There were no other significant complications.

Conclusion: Some patients may be treated safely as out-patients using oral pain relief with no significantly greater re-admission or complication rates than inpatients. An important factor in day-case treatment in this study was that having surgery early in the day allowed more time in hospital for recovery . Drowsiness and nausea after operation, and social factors at home were more important factors than pain.