ACL reconstruction - discharge
You had surgery to repair a damaged ligament in your knee called the anterior cruciate ligament (ACL). This article tells you how to care for yourself when you go home from the hospital.
ACL injury - Animation
Let's talk today about ACL injuries. Do you remember that old children's song that goes, The knee bone's connected to the thigh bone, and so on? Well the thigh bone's connected to the shin bone, and one of the four ligaments that connects these two bones is called the anterior cruciate ligament or ACL. The ACL sits in the middle of the knee. It's main job is to prevent the shin bone from sliding in front of the thigh bone. So, how do most ACL injuries occur? Well, getting tackled in football is just one way to hurt your ACL. You could also over extend your knee joint while playing other sports, like basketball or soccer, or while skiing. Or, you could injure your ACL if you quickly change direction while running, or land the wrong way from a jump. Some ACL tears are just partial, while others are complete. The injury that has damaged your ACL can also tear other ligaments or cartilage in your knee. So, what should you do if you think that you might have a torn ACL? Well, if you've injured your knee and it swells up, hurts, or makes a popping sound, or gives way while you walk, you could have an ACL injury. So, stop whatever that you're doing; even if you're just about to score the game-winning touchdown. Try not to move your knee. See your doctor as soon as you can because you may need an MRI or x-ray so your doctor can see exactly what type of injury that you have. You can treat an ACL injury with ice, rest, and pain relievers such as ibuprofen or acetaminophen. But you may also need physical therapy to get your knee moving normally again. If the tear is so bad that you can barely walk on your leg, your doctor may recommend surgery to rebuild your torn ACL. Whenever you run, jump, or play sports, take it easy on your knees. Talk to your doctor or a physical therapist about ways to prevent knee injuries during play. And if you ever hurt your knee so badly that your foot turns blue and feels cool to the touch, get medical help immediately because that's a sign that you've dislocated your knee joint, and you may have injured the blood vessels to your foot.
When You're in the Hospital
You had surgery to reconstruct your anterior cruciate ligament (ACL). The surgeon drilled holes in the bones of your knee and placed a new ligament through these holes. The new ligament was then attached to the bone. You may also have 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. It can take from a few days to a few months to be ready to return to work. How soon you return to work will depend on the kind of work you do. It often takes 4 to 6 months to return to your full level of activity and take part in sports again after surgery.
Your health care provider 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 week after surgery. Do not put the pillow behind your knee. Keep your knee straight.
- Be careful not to get the dressing on your knee wet.
- Do not use a heating pad.
You may need to wear special support stockings to help prevent blood clots from forming. Your provider will also give you exercises to keep the blood moving in your foot, ankle, and leg. These exercises will also lower your risk for blood clots.
You will need to use crutches when you go home. You may be able to begin putting your full weight on your repaired leg without crutches 2 to 3 weeks after surgery, if your surgeon says it is OK. If you had work on your knee in addition to ACL reconstruction, it may take 4 to 8 weeks to regain full use of your knee. Ask your surgeon how long you will need to be on crutches.
You may also need 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 provider 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 most often begins about 1 to 2 weeks after surgery, however you can do some simple postoperative knee exercises immediately after surgery. The duration of physical therapy may last 2 to 6 months. You will need to limit your activity and movement while your knee mends. Your physical therapist will give you an exercise program to help you build strength in your knee and avoid 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.
You will go home with a dressing and an ace bandage around your knee. Do not remove them until the provider says it is OK. Until then, keep the dressing and bandage clean and dry.
Dressing and bandage clean and dry
An incision is a cut through the skin that is made during surgery. It is also called a surgical wound. Some incisions are small, others are long. ...Read Article Now Book Mark Article
You can shower again after your dressing is removed.
- When you shower, wrap your leg in plastic to keep it from getting wet until your stitches or tape (Steri-Strips) have been removed. Make sure that your provider says this is OK.
- 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. 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. Keep wearing the ace bandage until your provider tells you it is OK to remove it.
Pain is normal after knee arthroscopy. It should ease up over time.
Your provider will give you a prescription for pain medicine before your surgery. Get it filled ahead of time so that you have it when you need it. Take your pain medicine when you start having pain so the pain doesn't get too bad.
You may have received a nerve block during surgery, so that your nerves do not feel pain. It is normal that your leg will feel a bit numb after the nerve block. The numbness can last for hours and sometimes up to a day. Make sure you take your pain medicine, even when the block is working. The block will wear off, and pain can return very quickly.
Ibuprofen (Advil, Motrin) or another medicine like it may also help. Ask your provider 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 provider 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 (38.3°C)
C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Brotzman SB. Anterior cruciate ligament injuries. In: Giangarra CE, Manske RC, eds. Clinical Orthopaedic Rehabilitation: A Team Approach. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 47.
Hantes ME, Tsarouhas A. Anterior knee problems after anterior cruciate ligament reconstruction. In: Prodromos CC, ed. The Anterior Cruciate Ligament: Reconstruction and Basic Science. 2nd ed. Philadelphia, PA: Elsevier; 2018:chap 136.
Micheo WF, Sepulveda F, Sanchez LA, Amy E. Anterior cruciate ligament sprain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 63.