ACL Reconstruction Post-op Instructions

Michael E. Higgins, M.D.

Weight bearing

  • Unless instructed otherwise you may walk on your leg immediately after surgery as tolerated.  Crutches or a walker are provided to be used as needed.  Too much walking the first 3-4 days after surgery may cause increased swelling in the knee.

 

Bracing

  • You may be placed in a range of motion brace after surgery.  This will in most cases be set at 0-90 degrees of flexion and should be worn when walking.  It may be removed for therapy and may also be removed while sleeping.

 

Ice

  • Ice will be your friend for the first several days after surgery.  Icing you knee will help to minimize swelling and help relieve pain or discomfort.  A bag of ice, or frozen vegetables wrapped in a towel works well.  Apply ice to the knee and replace as needed.  If your knee is too cold take a break, but otherwise don’t bother with the 20 minutes on 20 minutes off routine.

 

Pain Medication/Prescriptions

  • A narcotic pain medication will be prescribed for pain control at home, usually hydrocodone.  Take as needed for pain control.  In the first 3-4 days after surgery it is usually best to take the medicine if you start to have pain to “stay in front of the pain”.  If you are not in pain do not take the medicine.  Beyond the first few days after surgery most patients are able to significantly decrease their use of narcotic pain medications.
  • An anti-nausea medicine is prescribed, usually Phenergan. Take this medication if the pain medicine makes you nauseous.
  • If you are prone to constipation or have experienced constipation with pain medication in the past over the counter stool softeners and or milk of magnesia should be started with pain medication after surgery and taken as needed to avoid constipation.
  • An anti-inflammatory medication is prescribed, usually Meloxicam or Mobic.  This medication is for both relieving inflammation as a bonus it helps with pain although it is not a narcotic.  This medication should be taken for 30 days after surgery, a refill is provided on the script to be used if you notice increased pain after completing the first 30 days. 

 

  • An adult Aspirin (325mg) should be taken daily for 4 weeks after surgery.  There is a small risk of developing a blood clot in your leg after surgery and aspirin diminishes this risk.

 

Knee Dressing

  • If the dressing is too tight you can remove the ace wrap and reapply. 
  • The dressing in your knee should be changed 2 days after surgery.  The ace wrap may be reused with a gauze.   
  • The incisions can be cleaned gently with antibacterial soap and water or hydrogen peroxide.  You can apply a small amount of Neosporin or its generic equivalent to the incisions daily if you wish but this is not necessary.
  • The incisions may be kept open to air as long as they are dry (no drainage).
  • There will likely be some drainage on the dressing when it is changed and a small amount of drainage for a day or two after the first dressing change is normal.  If the incisions are draining beyond 5 days after surgery call the office Dr. Higgins will want it to be evaluated.

 

Bruising

  • Bruising on the thigh, calf or ankle may develop after surgery.  Ice theses areas as needed.

 

Showering

  • You may shower on the 7th day after surgery as long as the incisions are dry (no drainage).  The incisions should be covered/kept dry while in the shower.  Waterproof band aids work well for this.  Do not submerge your knee under water until your stitches are removed.

 

Fevers

  • Low grade fevers (less than 101) are common after surgery and generally last only a short period of time.  These fevers are most often caused by mucus in your lungs.  Deep breaths, coughing, and moving around a bit are usually all that is needed.  If you are having fevers shortly after surgery the chances of that fever coming from an infection at the surgical site is very low.

 

Driving

  • There is not a time limit that must be met before you can drive.  There are criteria to drive and when you are ready is different for different people.  Most patients are ready to drive just a few days after surgery.  To drive you need to be able to operate the vehicle safely.  That means you should not take narcotic pain medicine and drive.  You need to be comfortable and confident you can slam on the brakes in an emergency.  If you are not sure you are ready to drive go to an empty parking lot and practice first.

 

Exercises

  • Physical therapy should be scheduled to begin 2-3 days after surgery.  Your therapist will give you a home exercise routine.  Some exercises you can do on your own right after surgery are listed below
    • While seated, bend and straighten your knee as much as comfort will allow 20 repetitions 3 times daily.  This helps to reduce stiffness in the knee.
    • While seated, tighten the thigh muscles (quadriceps) for 5 seconds and then relax.  Repeat 20 times 3 times daily.  This helps to reawaken the thigh muscles which may be a little weak right after surgery.
    • Short walks can be helpful and are encouraged.  Start with 1/8 or 1/4 mile a few days after surgery and slowly increase the distance daily. 

 

Please Call the Office with Significant Concerns

757-827-2480