ACL reconstruction - discharge

You had surgery to repair your anterior cruciate ligament (ACL). In this procedure, your surgeon drilled holes in the bones of your knee and placed a new ligament through these holes. Then your surgeon attached the new ligament to the bone. If you needed it, you may have also had surgery to repair other tissue in your knee.

What to Expect at Home

You may need help taking care of yourself when you first go home. Plan for a spouse, friend, or neighbor to help you. How soon you return to work will depend on the kind of work you do. It can be anywhere from a few days to a few months. A full return to activities and sports usually takes 4 to 6 months.

Activity

Your doctor will ask you to rest when you first go home. You will be told to:

  • Keep your leg propped up on 1 or 2 pillows. Place the pillows under your foot or calf muscle. This helps keep swelling down. Do this 4 to 6 times a day for the first 2 or 3 days after surgery. Do not put the pillow behind your knee. You want to keep your knee straight.
  • Be careful not to get the dressing on your knee wet.
  • NOT to use a heating pad.

Your doctor may ask you to wear special support stockings to help prevent blood clots from forming. You will also learn exercises to do that will keep blood moving in your foot, ankle, and leg. These exercises will also lower your risk of blood clots.

You will use crutches when you go home. You may be able to put your full weight on your repaired leg, without crutches, 2 weeks after surgery. But, it may be as long as 4 to 8 weeks if you had other work done on your knee besides ACL repair. Ask your surgeon how long you will need to be on crutches.

Your surgeon may also ask you to wear a special knee brace. The brace will be set so that your knee can move only a certain amount in any direction. Do not change the settings on the brace yourself.

  • Ask your doctor or physical therapist about sleeping without the brace and removing it for showers.
  • When the brace is off for any reason, be careful not to move your knee more than you can when you have the brace on.

You will need to learn how to go up and down stairs using crutches or with a knee brace on.

Physical therapy usually begins about 2 weeks after surgery. It may last 2 to 6 months. You will need to limit your activity and movement while your knee slowly mends. Your physical therapist will put you on an exercise program that will help you build strength and keep your knee safe from injury.

Staying active and building strength in the muscles of your legs will help speed your recovery.

Getting full range of motion in your leg soon after surgery is also important.

Wound Care

You will go home with a dressing and an ace bandage around your knee. Do not remove them until the doctor or nurse says it is okay. Until then, keep the dressing and bandage clean and dry.

You can shower again after your dressing is off.

  • When you shower, wrap your leg in plastic to keep it from getting wet until your stitches or tape (Steri-Strips) have been removed.
  • After that, you may get the incisions wet when you shower. Be sure to dry the area well.

If you need to change your dressing for any reason, put the ace bandage back on over the new dressing. Keep the ace bandage on until your doctor or nurse tells you it is okay to remove it. Wrap the ace bandage loosely around your knee. Start from the calf and wrap it around your leg and knee. Do NOT wrap it too tightly.

See also: Surgical wound care

Pain

Pain is normal after knee arthroscopy. It should ease up over time.

Your doctor will give you a prescription for pain medicine. Get it filled when you go home so that you have it when you need it. Take your pain medicine when you start having pain. Waiting too long to take it will allow your pain to get more severe than it should.

You may have received a nerve block during surgery, so that your nerves don't feel pain. Make sure you take your pain medicine even when the block as working. The block will where off, and pain can return very quickly.

Ibuprofen (Advil, Motrin) or another medicine like it may also help. Ask your doctor what other medicines are safe to take with your pain medicine.

Do NOT drive if you are taking narcotic pain medicine. This medicine may make you too sleepy to drive safely.

When to Call the Doctor

Call your doctor or nurse if:

  • Blood is soaking through your dressing, and the bleeding does not stop when you put pressure on the area
  • Pain does not go away after you take pain medicine
  • You have swelling or pain in your calf muscle
  • Your foot or toes look darker than normal or are cool to the touch
  • You have redness, pain, swelling, or yellowish discharge from your incisions
  • You have a temperature higher than 101 °F.

Alternate Names

Anterior cruciate ligament repair - discharge; ACL repair - discharge

References

Amy E, Micheo W. Anterior cruciate ligament tear. In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 55.

Phillips BB. Arthroscopy of the lower extremity. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 48.

Reconstruction of the ACL with a semitendinosus tendon graft: a prospective randomized single blinded comparison of double-bundle versus single-bundle technique in male athletes. Streich NA. Knee Surg Sports Traumatol Arthrosc. March 1, 2008; 16(3): 232-8.

Update Date: 12/20/2012

Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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