ACL Reconstruction Post-Operative Patient Instructions
These instructions are for patients that have not had a meniscal repair
Below is a list of instructions to follow during the first several weeks after your ACL reconstruction surgery. It is extremely important that they are followed in order to maximize your recovery process and avoid complications. The physical therapist or physician will notify you if there are any exceptions to these rules for your case. If you have any questions, please ask the physical therapist or physician.
Brace and Crutch Use
Your brace should be locked in zero degrees of extension (fully straightened) while standing and walking. Initially, two crutches should be used while walking. The therapist will instruct you on the correct walking sequence. Your brace may be unlocked or removed while seated, and should be removed while sleeping. Ask your therapist if you have any questions regarding the appropriate fitting of your brace and/or crutches.
It is usually appropriate to discontinue use of the brace after two weeks. It may be possible to use only your crutches (without the brace) for a short time period to prevent any abnormalities with your walking pattern. In some cases, continued use of the brace alone (without the crutches) is appropriate. The physical therapist will instruct you on the appropriate progressions and time frames for brace/crutch usage in your specific case. Most patients will walk without a brace or crutches by 14 days after surgery.
Weight-bearing through your operated leg is permitted and encouraged following the surgery. However, you should still continue to use your brace and crutches as instructed. It is important that you place weight through your operated leg as early as possible following the surgery to prevent muscles in that leg from weakening.
Keep this area clean during the first few weeks after surgery until all incisions have healed. The physical therapist will remove your sutures during the first two weeks after the surgery. Notify the physician or physical therapist if you notice any drainage or odor coming from your incisions.
Once the physical therapist has removed your bandaging, it is safe to shower. It is important to avoid submerging the operated leg underwater. Avoid scrubbing over the incisions. When drying yourself after a shower, pat the incisional area dry with a towel.
Once you are no longer using your brace, driving may be resumed at your comfort if you are not using narcotic pain medication. Do not drive if you do not feel safe doing so.
It is important to adhere to your home exercise program on a regular basis to regain your knee flexibility as quickly as possible following the operation. The physical therapist will provide you with an individualized home program that is specific to your needs. It is important to frequently move your knee. You should not sit in one position for longer than 45 minutes at a time.
Electrical Stimulation Unit Use
You may be given an electrical stimulation unit to use at home. If so, the unit should be used for 1-2 hours per day in order to facilitate activation of your quadriceps muscles. The physical therapist will instruct you on the appropriate set-up and use of this machine. Following ACL reconstruction, it is common for the quadriceps muscles not to fire adequately.
Use of this machine may be discontinued once the physical therapist has determined that you are able to fully activate your muscles. You will find a mailing envelope enclosed in the original packaging of the electrical stimulation unit. This envelope can be used to ship the unit back to the manufacturer once you are no longer using it.
Management of Pain and Swelling
Pain and swelling are expected in your knee following surgery. However, it is important to notify the physical therapist or physician if you begin to notice significant swelling or sharp pain in your calf area. Although unlikely, this could be a sign of a blood clot.
To help decrease the swelling in your operated knee, lie on your back with the operated leg propped up so that it is elevated higher than your heart. This should be done frequently throughout the day until swelling has subsided. Initially following your operation, it may be appropriate to do this several times a day.
Application of ice over your operated knee may help to manage pain and decrease inflammation following your surgery. This should be done for 15 minutes at a time, followed by at least 45 minutes without ice. Initially following your operation, it is appropriate to use ice several times a day. Use of ice can be combined with elevation of your leg, as explained above.
Speak with the physician regarding appropriate use of pain medications.