Anna Watkin, Kim Russon, Andrew Legg, Alex Anderson, Kayleigh Wright, Tammy Hayward
Rotherham Foundation Trust, Rotherham, United Kingdom
Introduction: Knee arthroscopy and partial meniscectomy are common procedures, with most patients satisfied with the outcome. Some, however, develop compartmental pain due to the lack of functioning meniscus, known as post meniscectomy syndrome.
Meniscal Allograft Transplant (MAT) uses a donor’s meniscus to help unload the articular cartilage and help with pain relief. It is an arthroscopic procedure lasting 2-3 hours. Although generally performed on young, healthy patients and described as an outpatient procedure in America, we are unaware of it being performed as a day case in the UK. We report how we introduced day case MAT to Rotherham NHSFT.
Methods: A multidisciplinary day surgery pathway was developed including listing for surgery, pre-operative preparation, admission, pre-medication, anaesthesia, surgery and discharge medication. Prospective data collected included anaesthesia, analgesia, anti-emesis, pain scores, physiotherapy assessments and patient satisfaction.
Results: Between November 2022 and January 2023, two patients had MAT. Both were successful day cases managed with premedication (paracetamol, ibuprofen, oxycodone), general anaesthetic, intra-operative intravenous fentanyl 250mcg and local anaesthesia. Both were discharged by 4.30pm.
Both patients reported pain day one post-operatively, ranging from mild to severe. One patient contacted their GP, increasing their oxycodone dose. Both reported being happy to have been managed as day cases, although one stated they felt unprepared.
Conclusions: We conclude day case MAT surgery can be safely performed. Although annual numbers are low, 3-4 in our Trust and nationally 200-300, we would suggest that this can free up valuable inpatient beds and support recovery of elective surgery.