Post ACL Reconstruction Instructions

Immediately after surgery you can expect some pain and swelling. Everyone is different as is each surgery, so don't compare your recovery with others. You need to keep ice on the knee as much as possible (at least 30- 40minutesevery two hours) or use the cryo-cuff continuously. Ice is most important over the first 24-48 hours, but should be continued for several days longer. Make sure that you feel the cooling effect. If your hamstrings were used for the graft, you can expect to have some pain in the inner portion and back of your thigh. It is not unusual to develop swelling and bruising on the inner thigh and calf.

  1. ACTIVITY
    Although the incisions ate small, your knee has undergone quite a bit of surgery. During the initial several days WALKING SHOULD BE LIMITED to that which is necessary and reasonably comfortable. Try to keep the leg elevated as much as possible and avoid long periods of time with the leg down. Increased pain and swelling indicates that you should reduce your activity level. Placing weight on the leg and walking is of no harm unless specifically indicated by us. Crutches should be used for as long as you need them for comfort and balance. Don't give the crutches up until you can walk without a limp (usually at least 2 weeks). Begin the exercises as instructed on the last page. The ankle pumps are important to start immediately. The other exercises may be phased in over the first two weeks. It is sometimes difficult to get your knee fully straight after ACL surges We, therefore, encourage you to try and straighten your knee as soon as possible after the surges Avoid keeping pillows directly behind the knee. It is better to place the pillow under the calf.
     
  2. MEDICATIONS
    You may have been given a pain killed anti-inflammatory to take the night before your surgery (Ibuprofen). Continue this for the first week after the surgery. You will also be given a prescription for a strong pain killer. Use only as necessary and never more than prescribed. We also recommend that you do not drive while on this medication. After the first week: Tylenol, Advil, or Ibuprofen should provide you with enough pain relief and we encourage you to try and transition to these alternative pain medications as soon as you are able. We also recommend that you take one aspirin tablet each day unless you are allergic to aspirin or have a history of ulcer disease or gastritis. This will help prevent blood clot formation in your leg.
     
  3. DRESSING AND SHOWER INSTRUCTIONS
    Change the bandage daily after post-op day 2. You may use gauze bandages or band aids. Reapply ace bandage to knee. Don't apply too tightly. You should not shower or get the incision wet until after the fourth day as long as there is no continued drainage from the incision site. If there is any drainage under the bandage, cover the incision and try again the next day.
     

Questions:

When can I drive?
You can drive when you can easily get into and out of the car without difficulty, when you have enough control of your leg that you can feel safe and confident behind the wheel and you are no longer taking pain medications. This is usually about 2 - 3 weeks for the left knee and 3 - 4 weeks for the right knee.

When can I return to work or school?
This really depends upon the demands of your job. Plan to take at least 7 - 10 days off of work or school. More physically demanding jobs may take 3 - 4 months to return to.

When can I run?
Running is allowed after full range of motion, good strength and proprioception (balance) is attained. The earliest you can begin running straight ahead on a level surface is 8 to I0 weeks but often it takes 3 - 4 months. Your physical therapist will help guide you.

Do I need a Brace?
We usually do not prescribe a brace immediately following your surgery but do recommend a functional derotation brace during “at risk” activities as you return to sports. This will be prescribed around 3 to 4 months postoperatively if you do not already have one. We recommend you use this brace for these activities for at least the first two years.

When can I return to sports?
You may return to “at risk” sports, those which require cutting and twisting (ie. Soccer, basketball) or are unpredictable (ie. Skiing, football) only after you have regained your full range of motion, strength and balance. This is usually takes about 6 months but never less than 4 months.

POTENTIAL PROBLEMS:

A range of surgical procedures done arthroscopically makes the recovery course and improvement times variable. You should not compare your course with that of other individuals. There are certain potential “deviations” from the routine course that you should be aware of.

    1. BLEEDING OR DRAINAGE
      Drainage is expected. A large amount of fluid is used during the procedure and this will drain out of the incisions. If the dressing becomes saturated, apply another one. If drainage continues after 24 hours or you think the drainage is excessive…….Call the office.
    2. FEVER
      If you have a temperature greater than 101 degrees on more than one reading 48 hours or more after surgery……..Call the office.
    3. SWELLING
      Swelling, numbness, coldness and tingling are not uncommon. It may be an indication that the ace bandage is too tight. Loosen it and elevate your leg. If you feel that you are having increasing swelling in the calf or foot……..Call the office.
    4. DISCOLORATION
      You can expect discoloration (black and blue changes) in the back of your thigh and calf, especially if the hamstrings were used for you graft. Continue to ice and stretch. Don’t worry about discoloration, but call if there is pain in the calf that is getting worse instead of better.
    5. UNRELENTING PAIN
      If pain remains severe 48 hours after surgery……..Call the office.

    If you have not yet made your follow up appointment, please call the office and do so.

Lawrence H. Fein, MD
William T. Byrt, MD
William W. O’Connor, MD
George E. Silver, Jr., MD
John C. Herzog, DO Bruce Dick, MD
Joseph Larosa, MD