Authors: (including presenting author): :
Tam KS(1), Fung YK(1), Cheung WY(2), Yiu L(2), Cheng CW(1), Lau KC(2), Lam CW(2), Law KC(1), Tang CY(1), Keung MY(1)
Affiliation: :
(1)Physiotherapy Department, (2)Department of Orthopaedic and Traumatology, Tseung Kwan O Hospital
Keyword 1: :
Anterior Cruciate Ligament Reconstruction
Keyword 3: :
Same Day Discharge
Keyword 4: :
Orthopaedic-Physiotherapy Collaboration
Keyword 5: :
Prehabilitation
Introduction: :
The transition of anterior cruciate ligament reconstruction (ACLR) from inpatient to day-case care represents a significant advancement in Orthopaedic surgery and rehabilitation practice. Safe same-day discharge (POD0) after ACLR depends on close multidisciplinary collaboration between surgeons and physiotherapists- optimizing patients’ preoperative functional readiness and a well-coordinated postoperative rehabilitation pathway.
Objectives: :
A new Orthopaedic–physiotherapy collaborative initiative was launched since 3Q 2025 to pilot an integrated model of care for ACLR patients at TKOH. This service evaluation reports the early outcomes of this pilot programme.
Methodology: :
A prospective observational service evaluation was conducted between July and December 2025. The integrated pathway featured joint preoperative case conferences involving Orthopaedic surgeons and physiotherapists to align surgical decisions, rehabilitation goals, and discharge criteria. A physiotherapist-led prehabilitation programme was implemented 3-4 months before operation to optimize patients’ physical and psychological readiness for POD0 discharge.
Patients who underwent primary ACLR, with or without concomitant meniscus repair, were included. Once the patient was clinically stable in the day-surgery unit after operation, they would be assessed by a physiotherapist for suitability for same-day discharge. On site ambulation assessment and training, pain management and home care education would be provided concurrently. Telehealth consultations by both the surgeon and physiotherapist supported ongoing monitoring, progress tracking, and reinforced adherence to rehabilitation pathway.
Result & Outcome: :
Nine patients (mean age 25.3 ± 6.4 years; 67% male) were included, of whom 78% (n = 7) underwent concomitant meniscus repair. Same-day discharge was achieved in 77.8% (7/9) of cases. On POD0, patients achieved an average walking duration of 38.0 minutes. Mean pain scores (NPRS) peaked at 3.6 on POD1 and declined to 1.6 by POD4. Mean sleep quality scores remained ≥6.6/10 across POD0–4. The tele-rehabilitation completion rate was 66.7% (6/9). Median patient satisfaction was 4.0/5, with 80% indicating they would choose the day-case pathway again. Conclusion This Orthopaedic–physiotherapy collaborative model, integrating structured prehabilitation with early tele-rehabilitation, demonstrated high same-day discharge rates with favorable short-term recovery outcomes following ACL reconstruction. These findings support the feasibility and safety of shifting ACLR care toward a day-case model with POD0 discharge.
