Recovery After ACL Reconstruction

You will be in the recovery room for an hour or two until you are fully awake and comfortable for discharge.  Your physical therapy should begin within 1-4 days after surgery to begin working on muscle activation and range of motion.  To prevent blood clots, you will be given some simple ankle exercises to move your ankle and contract your calf muscles.

Surgery can amount to an early morning plus the medication of anesthesia which can leave you tired.  You should elevate your leg above the level of your heart to improve swelling, with pillows under the heel or calf so the knee stays straight.  Numbness around your knee as well as bruising can be normal and will resolve in a few days.  Icing the knee can be helpful immediately following surgery, 20 minutes on and 20 minutes off followed by repeating.

You will be on crutches immediately after surgery with most patients being allowed to bear full weight on the surgical leg, depending on the extent of the injury to your knee.  It is recommended you wear the brace at all times, in the locked straight position, so you do not buckle the knee and injure yourself.  Wear the brace for going up and down stairs and at rest at night.  The brace can come off for showering or if you find it difficult to sleep with it on.

Crutches are usually discontinued after a week or two when your muscle activation returns and you can walk without a limp.   If you had an additional injury treated at the time of surgery such as a meniscus repair, the period of crutch use may be extended a couple weeks.

You will be recommended a nerve block prior to the surgery which is performed by an anesthesiologist that helps substantially with pain for the first day or so following surgery.  There is normal variation about how well (dense) the numbing effect of the block works, and do not be alarmed if you still need a pain medication in the recovery unit or at home following surgery.  Take the pain medications as directed, usually every four to six hours, supplementing with an NSAID such as ibuprofen as needed.

You will have sterile (aseptic) bandages applied at the time of surgery.  These bandages help to keep the incisions clean, to soak up and remove any oozing of fluids from the incisions, and for a compressive effect to assist swelling.  For these reasons it is recommended you retain the surgical bandages in place for a few days, generally allowing the therapist to remove them at your first appointment.  If the therapist has not removed them within five days following surgery, you may peel them off on your own.  Once the bandages come off you can begin to shower, letting water gently run over the incisions.  Leave the little stickers called steri- strips in place as they will peel off in their own in a week or so.  Do not scrub the incisions or submerge the knee under water in a pool until given instructions by knee surgeon Dr. Obermeyer or his team to do so.

You may perform exercises to lightly bend and fully straighten the knee as well as to perform straight leg raises shortly after surgery.  Your therapist will provide further instructions on exercises for range of motion and strengthening.

If you are experiencing continued drainage from the surgical incisions, have worsening or uncontrolled swelling or pain, or if you are spiking a temperature above 101 degrees you should contact the office for further instructions.

You may return to driving around two to three weeks when you are walking independently, confident with your mobility, and able to safely get into and out of a car.

Rehabilitation generally begins within 1-4 days after surgery and will continue for a few months. While the recommendations for your activity progression depend on the status of your motion and muscle strength, the overall timeline is generally predictable. Knee surgeon Dr. Obermeyer has rehabilitation guidelines although the specifics of your exercise routine will be developed with your physical therapist.

Stationary bike riding can be started within 4 to 12 weeks after surgery to help swelling, to get the knee to bend and to straighten, and to activate the quadriceps.  Running is generally begun at 3 to 4 months after surgery.  Agility and sport-specific exercises are generally started at 4 months pending the successful completion of previous stages and milestones.