ACL Reconstruction Post-Operative Care

The following are post-operative instructions for patients who have undergone arthroscopic Anterior Cruciate Ligament surgery to their knee. Please refer to this reference sheet, which should probably answer most of the questions you might have. If you have further questions that need immediate answering, contact our office at (970) 879-BONE (2663).

FIRST OFFICE VISIT AFTER SURGERY:
We try to schedule your first post-operative visit prior to your arthroscopic surgery. If you do not, we call all patients the day after your surgery and your first post-operative visit can be scheduled at that time. This first visit is usually two or three days after your surgery. If you live very far away, special consideration is given and other arrangements can be made (e.g. you live in the Winter Park, Granby, Craig or Kremmling area).

CRUTCHES/BRACE:
On your post-op directions the exact amount of weight bearing will be specified. Even if it states full weight bearing we prefer that you unload the leg by using a pair of crutches for a couple of days. Your brace will have the settings set and this will be reviewed in your post-operative visit so please do NOT adjust the brace settings until instructed.

DRESSINGS AND SUTURES:
You will have a bulky dressing over your knee. Although it is very unlikely, you may notice some bloody spotting coming through the outer Ace wrap. It is important for you to watch this area, and contact us if it continues to spread. Otherwise, any small area of spotting will dry and can be ignored until we remove the dressings. The dressing will be changed by your doctor or their nurse on your first office visit after your surgery. The sutures utilized in closing any wounds are either an absorbable suture, nylon suture or staples. You are not to remove them under any circumstance.

ICE:
Ice and elevation will help minimize the pain and swelling after surgery, especially during the first few days. Elevation, to be effective, involves keeping your knee and lower leg above the level of your heart. You can keep ice packs on the knee continually during the first few days without risk of frostbite injury to the underlying skin as long as the original dressings are in place. The initial post-operative wrap involves multiple layers of cotton gauze and padding, therefore insulating the skin surface reasonably well. When the original dressing has been removed only the Ace compressive wrap and a light dressing will be used. I would then recommend ice applications to the anterior knee region for 20 minutes at a time, a few times each day. Be sure to use towels under the ice and change them frequently to prevent this from happening.

SHOWERS:
You cannot shower until after your first office visit. Once your dressing has been changed and there is no further drainage, showering is permitted. If there is any noticeable or persistent drainage from the incision sites, or any surrounding red areas, please contact us immediately. DO NOT SUBMERGE YOUR SURGICAL INCISION UNDER WATER (hot tub, bath tub, lake, pond, river, etc) until your sutures have been removed and you are given permission by your doctor or their nurse.

PHYSICAL THERAPY:
This will be discussed both before and after your surgery. If you know you will be receiving physical therapy, you will be supplied with a prescription at your first post-operative visit or it will be faxed directly to your therapist.

MEDICATIONS:
You will be provided with a prescription for a pain medication when you are ready to leave the hospital. Usually we will prescribe Hydrocodone or Oxycodone. These are both generic names for two different narcotic pain relievers. If you are aware of a certain pain medication that you have previously had problems with, or one that you normally respond favorably to, please inform us so that we can give you the appropriate prescription. You may have the prescription prior to surgery to avoid filling it the day of surgery. You might also be given a prescription for an anti-inflammatory medication Toradol (ketorolac) that will help lessen pain and swelling. Tylenol and Acetaminophen are the same medicine. You should not use Tylenol if you are using the Percocet/Roxicet or Lorcet prescription medications since they already contain tylenol/acetaminophen. If in doubt check the prescription label to be sure acetaminophen is not in your medication. We try and avoid over-the-counter anti-inflammatory medications such as Ibuprofen (Advil, Aleve, Nuprin, etc.). If you have a history of ulcers or of stomach irritation with aspirin or anti-inflammatory drugs, then you should avoid using Toradol. Please try to anticipate the need for any refills on your pain medication, and contact our office early in the day the day before running out completely. I cannot provide prescription refills after business hours or on weekends, so please plan ahead.

COMPLICATIONS:
The incidence of an infection deep within the joint is literally less than 1/2 percent. Onset of symptoms would be approximately 5-7 days following surgery, and would consist of a significant increase in pain, swelling, warmth, and redness of the surgical area, fever, chills or night sweats. More common, but still quite rare, would be a small superficial infection or irritation at one of the skin incisions. There can also be a very small incidence of a blood clot developing deep within your arm or leg veins. This would be characterized by a sudden onset of new pain, usually different from your surgical pain. This usually begins about 5-7 days from the day of surgery. The presence or absence of a clot can usually be determined by a simple non-invasive ultrasound test at the hospital.

Contact our office for any concerns at 970-879-BONE (2663).