Comparison of Day-Care Versus In-Patient Acl Reconstruction in Terms of Postoperative Pain and Patient Satisfaction: A Prospective Randomized Study (N=30)

Abstract

Background: Health systems increasingly favor same-day discharge after anterior cruciate ligament reconstruction (ACLR) to reduce costs and improve patient flow; however, concerns persist regarding early postoperative pain control and patient experience. Prior randomized evidence suggests outpatient ACLR can yield equal safety and higher satisfaction, but results vary across pathways and settings.

Methods: A prospective randomized study was conducted in a tertiary orthopedic center over 12 months. Thirty adults undergoing primary arthroscopic ACLR with hamstring autograft were randomized 1:1 to day-care discharge (DC) or in-patient admission (IP). Pain was measured using a 0–10 visual analogue scale (VAS) at 6, 24, and 48 hours. Satisfaction was measured at postoperative day 7 using a 0–100 satisfaction VAS (higher scores indicating greater satisfaction). Secondary outcomes included rescue opioid use, postoperative nausea/vomiting (PONV), unplanned contacts, and readmissions within 7 days. Between-group comparisons used independent-samples tests; pain trajectories were assessed with mixed-effects modeling.

Results: Baseline characteristics were comparable between groups (mean age 26.9±5.4 years; 70% male). Mean VAS pain scores (DC vs IP) were 5.2±1.3 vs 4.6±1.4 at 6 h (p=0.18), 3.4±1.1 vs 3.6±1.2 at 24 h (p=0.62), and 2.1±0.9 vs 2.3±1.0 at 48 h (p=0.55). Satisfaction at day 7 was higher in DC (88.1±7.6) versus IP (79.4±9.8), mean difference 8.7 points (95% CI 1.8–15.6; p=0.016). Rescue opioid consumption and PONV rates were not significantly different. No participant required hospital readmission within 7 days.

Conclusion: In this randomized cohort (n=30), day-care ACLR achieved pain outcomes comparable to in-patient care while producing meaningfully higher patient satisfaction, without increased early adverse events. These findings support structured day-care pathways for appropriately selected ACLR patients.