Rotator cuff repair as an outpatient procedure.

The purpose of this study was to evaluate outpatient rotator cuff repair on the basis of patient satisfaction, pain control, early postoperative complications, and cost control. Patients were considered good candidates for an outpatient repair if they were in good health and had adequate support at home. Seventy-five rotator cuff repairs were performed on an outpatient basis. The average age of the patients was 58 years. Patients with tears smaller than 2 cm in diameter were excluded. Postoperative pain was managed effectively in 74 of 75 outpatients. There were no cases of deltoid origin compromise, deep infection, or early failure of repair, and no outpatient required readmission to the hospital. This study demonstrates that outpatient rotator cuff repair is possible in the appropriately selected patient and can be performed safely and effectively with a 43% reduction in overall cost.

Debridement arthroscopy. 10-year followup.

The treatment of osteoarthritis of the knee is a difficult problem. In the senior author's opinion, nonaggressive arthroscopic debridement of the knee is an effective procedure to relieve pain and restore function in patients with osteoarthritis of the knee. A subjective telephone interview of patients done 10 or more years after arthroscopic debridement evaluated the long term results of this treatment in patients with osteoarthritis of the knee. The patients all were candidates for total knee replacement who selected arthroscopy as a temporizing procedure. Of the 191 knees in patients undergoing arthroscopic debridement, 77 patients (91 knees) were contacted for followup. Sixty-seven percent of the 91 knees did not have total knee arthroplasty at an average of 13.2 years followup. The Tegner activity score averaged 3.5 and patient satisfaction averaged 8.6 on a 0 to 10 scale. Twenty-one patients (30 knees) or (33%) had total knee arthroplasty at an average of 6.7 years. Seven of these had total knee arthroplasty within 2 years of arthroscopic debridement. Six of these seven knees had Outerbridge Grade 4 articular cartilage changes and clinically significant meniscus tears. Seven of the 19 knees (37%) with Outerbridge Grade 4 changes in 80% of one knee compartment did not require total knee arthroplasty after greater than 10 year followup. The difficulties in long term followup in this patient population is evident, yet the number of patients who had a functional lifestyle after arthroscopic debridement was notable.