ACL Post-Operative Instructions
The following information is designed to answer some of the frequently asked questions regarding what to expect and what to do after ACL surgery. These are general guidelines, if you have any questions or concerns, please give Dr. Wilson’s office a call at (334) 749-8303.
Dressing and Wound Care
During ACL surgery, the joint is irrigated with water. There will typically be 4 small incisions and occasionally other larger incisions depending on the nature of your surgery. Your knee will be wrapped with gauze and then covered with an ace bandage. Water may gradually leak through these incisions, saturating the bandage. This blood tinged drainage may persist for 24–36 hours. If it has not significantly decreased by this time, please call our office.
Swelling in the leg, calf or ankle is usually due to constriction by the ace bandage. If it becomes too tight, the ace bandage should be loosened and the leg elevated above the level of the heart until the swelling decreases.
The gauze bandage may be removed 2 days after surgery and the incisions should be cleaned with hydrogen peroxide and water then covered with small band aids or dry gauze. As soon as the incisions are dry, you may leave them uncovered. Do not use ointments such as Neosporin on the incisions. You may shower 2 days after surgery, once the dressings have been removed. The incisions should not be soaked in water (i.e., bathtub, hot tub, swimming pool, etc.). If the incisions show any signs of infection, please contact our office. Specifically, if there is increased redness, persistent drainage, if you have fever > 100.4 degrees, or if the pain does not progressively decrease, you should call the office.
Reapplying the ace bandage for compression can help minimize swelling. It should be worn while you are up and about. Otherwise, avoid any constrictive dressings or bandages as they might increase the chance of complications.
Generally, Dr. Wilson has his patients wear a long hinged-knee brace for 2-6 weeks following ACL reconstruction to protect the surgery and allow early healing. The length of time that you need to wear the brace depends on the exact nature of your surgery. Please wear the brace around the clock except for showering and physical therapy for at least the first two weeks after surgery. Dr. Wilson will discuss with you at your follow-up appointments if longer brace wear is indicated. The hinges on the side of the brace can be unlocked to allow motion of the knee unless Dr. Wilson specifies otherwise.
During the first 48-72 hours, ice can be helpful to decrease pain and swelling and is especially important during the first 24 hours. Ice bags/packs should never be applied directly to the skin. They should be wrapped in a towel and applied for 20 minutes at a time every one to two hours. If the skin becomes very cold or burns, discontinue the ice application immediately.
Ambulation and Movement
Unless you have been otherwise instructed, you will be allowed to bear as much weight on your leg as is comfortable immediately after surgery. Crutches are usually necessary to help decrease discomfort. They are usually only needed for a few days to 2 weeks.
Elevation of your leg above the level of your heart can be very helpful in minimizing discomfort and swelling, especially in the first 48 hours following surgery. This is most easily accomplished by placing two to three pillows length wise under your knee so that your whole leg is supported.
Your level of discomfort will most often be your best guide in determining how much activity is allowed. Remember that it is very easy to “over-do” in the first few days after surgery and any increase in pain or swelling usually indicates that you need to decrease your activities. Please be careful on slippery surfaces, steps or anywhere you might fall and injure yourself. If you feel unsteady, ask someone to help you.
Getting Your Knee Straight
One of the most difficult things to do after knee surgery is to regain full knee extension, or straightening. Full knee extension is critical to walking without a limp. Working on getting the knee fully straight early after surgery allows a quicker return of full extension. Try not to put a pillow under your knee and have it rest in a bent position. This can lead to stiffness. Rather, place the heel on a pillow or other object (e.g. coffee table, sofa arm rest, etc.) and let your knee sag. This will be slightly uncomfortable but will pay off in the long run.
You will be given a prescription for pain medication. Please take the medications as directed on the bottle. If you have any known drug allergies, check with the nurse prior to taking any medication. Please note that we are unable to call in prescriptions for narcotics after office hours. If you need a refill, call the office early in the day so the nurse can call in your prescription. This is especially important if the weekend is approaching.
Some medications do have side effects. If you have any difficulty with itching, nausea, or other side effects, discontinue the medication immediately and call our office. Pain medication often causes drowsiness and we advise that you do not drive, operate machinery or make important decisions while taking medication.
Blood Clot Prevention
Aspirin serves as a mild blood thinner and may decrease the chance of blood clots forming in the leg. Although this is uncommon, it can be a difficult problem. If you are able to take aspirin, you should take one aspirin (325mg) once daily for two weeks following your surgery. Pumping your ankle and carefully moving your knee can encourage blood flow and prevent blood clots as well.
Physical therapy usually begins within the first week after your surgery, depending on the details of the procedure Dr. Wilson performed. The therapist will outline an exercise program specific to your type of surgery. The purpose of physical therapy is to help regain the mobility and strength in your knee. If you have any questions regarding your exercise program, please contact the physical therapist. If you are unsure about when or where your visit is, please call the nurse and she can help clarify what you need to be doing.
First Post-Operative Visit
Your first post-operative appointment will be made for you before you leave the hospital and is usually within a week or two following your surgery. The findings at surgery, long-term prognosis, and plans for rehabilitation will be discussed at this appointment. Please bring your arthroscopic pictures to this appointment for Dr. Wilson to review with you. If you are unaware of when your post-op appointment with Dr. Wilson is, please call the office and someone will help get you scheduled.
If you are having any problems, contact us right away. Please call the office number, (334) 749-8303. Dr. Wilson and his nurse are generally available during business hours. If it is after hours the answering service will contact the doctor on call.
Remember, if your pain increases, check for signs of infection (redness, drainage, fever, etc.), decrease your activities, use ice and take your pain medication as prescribed. If the pain persists, or if there are signs of infection, call our office.
Thank you for choosing Dr. Wilson as your surgeon. We look forward to getting you back to an active and pain-free life!