Skip to main content
NCBI home page
Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1998 Mar;80(2):146–149.

Day-case or short-stay admission for arthroscopic knee surgery: a randomised controlled trial.

A E Weale 1, C E Ackroyd 1, G V Mani 1, I G Winson 1
PMCID: PMC2503003  PMID: 9623383

Abstract

The Royal Colleges, The Audit Commission, and politicians have encouraged day-case care for patients undergoing arthroscopic knee surgery. However, there remains both public and professional concern regarding the acceptability and safety of this form of management, although there are clear economic benefits. In a prospective randomised controlled trial, 50 patients underwent arthroscopic surgery as a day-case and 50 patients were admitted overnight. Outcome was assessed by postal questionnaire 4 weeks after discharge. A linear visual analogue scale was used to measure pain levels. The response rate was 93%. The diagnoses and types of arthroscopic surgery were similar in both groups. In total, 94% of day-cases and 91% of patients admitted overnight expressed overall satisfaction. Pain after discharge was similar in both groups. Day-case management was preferred by 90% of day-case patients and by 64% of those admitted overnight. Of patients in the day-case group, 12% had to be admitted overnight because of recovery problems, but 7% of patients randomised to overnight stay discharged themselves. One patient admitted overnight required readmission because of a wound haematoma. Patients who had received day-case management returned to work significantly faster than those who had been admitted. Modern anaesthetic techniques with special attention to anti-emesis and pain control have reduced postoperative morbidity to acceptable levels. Provided that patients are properly selected and well informed, day-case care is preferable for the majority of patients undergoing arthroscopic surgery of the knee.

Full text

PDF
146

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allum R. L., Ribbans W. J. Day case arthroscopy and arthroscopic surgery of the knee. Ann R Coll Surg Engl. 1987 Sep;69(5):225–226. [PMC free article] [PubMed] [Google Scholar]
  2. Arvidsson I., Eriksson E. A double blind trial of NSAID versus placebo during rehabilitation. Orthopedics. 1987 Jul;10(7):1007–1014. doi: 10.3928/0147-7447-19870701-05. [DOI] [PubMed] [Google Scholar]
  3. Cardosa M., Rudkin G. E., Osborne G. A. Outcome from day-case knee arthroscopy in a major teaching hospital. Arthroscopy. 1994 Dec;10(6):624–629. doi: 10.1016/s0749-8063(05)80059-3. [DOI] [PubMed] [Google Scholar]
  4. Fenton-Lee D., Riach E., Cooke T. Patient acceptance of day surgery. Ann R Coll Surg Engl. 1994 Sep;76(5):332–334. [PMC free article] [PubMed] [Google Scholar]
  5. Geutjens G., Hambidge J. E. Analgesic effects of intraarticular bupivacaine after day-case arthroscopy. Arthroscopy. 1994 Jun;10(3):299–300. doi: 10.1016/s0749-8063(05)80116-1. [DOI] [PubMed] [Google Scholar]
  6. Hadden W. A., Nicol R. O. Day-patient meniscectomy: a feasibility study. J R Coll Surg Edinb. 1982 Jan;27(1):19–21. [PubMed] [Google Scholar]
  7. Heath P., Ogg T., Hall C., Brownlie G. The cost of day surgery. Health Trends. 1990;22(3):109–111. [PubMed] [Google Scholar]
  8. McLoughlin C., McKinney M. S., Fee J. P., Boules Z. Diclofenac for day-care arthroscopy surgery: comparison with a standard opioid therapy. Br J Anaesth. 1990 Nov;65(5):620–623. doi: 10.1093/bja/65.5.620. [DOI] [PubMed] [Google Scholar]
  9. Ogilvie-Harris D. J., Bauer M., Corey P. Prostaglandin inhibition and the rate of recovery after arthroscopic meniscectomy. A randomised double-blind prospective study. J Bone Joint Surg Br. 1985 Aug;67(4):567–571. doi: 10.1302/0301-620X.67B4.3839796. [DOI] [PubMed] [Google Scholar]
  10. Older J., Cardoso T. First year's experience of day-case arthroscopy in diagnosis and management of disorders of the knee joint. Lancet. 1983 Jul 30;2(8344):264–267. doi: 10.1016/s0140-6736(83)90243-x. [DOI] [PubMed] [Google Scholar]
  11. Redden J. F. Profile of half-day arthroscopic surgery in a district general hospital. Ann R Coll Surg Engl. 1988 Jul;70(4):224–226. [PMC free article] [PubMed] [Google Scholar]
  12. Russell I. T., Devlin H. B., Fell M., Glass N. J., Newell D. J. Day-case surgery for hernias and haemorrhoids. A clinical, social, and economic evaluation. Lancet. 1977 Apr 16;1(8016):844–847. doi: 10.1016/s0140-6736(77)92790-8. [DOI] [PubMed] [Google Scholar]
  13. Russell I. T., Devlin H. B., Fell M., Glass N. J., Newell D. J. Day-case surgery for hernias and haemorrhoids. A clinical, social, and economic evaluation. Lancet. 1977 Apr 16;1(8016):844–847. doi: 10.1016/s0140-6736(77)92790-8. [DOI] [PubMed] [Google Scholar]
  14. Smith I., Van Hemelrijck J., White P. F., Shively R. Effects of local anesthesia on recovery after outpatient arthroscopy. Anesth Analg. 1991 Nov;73(5):536–539. [PubMed] [Google Scholar]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England

RESOURCES