ACL Discharge information

Discharge Advice – ACL Reconstruction

Activity guidelines:

You can weightbear and walk as comfortable. You do not usually need a brace or crutches but you might find them useful during the first few days. Sometimes with additional procedures, such as meniscal repairs, a range-of-movement brace is necessary for 6 weeks to prevent harmful movement. You will not be able to drive for 6 weeks.

Hygiene:

During the first two weeks, until the wounds are healed, keep your dressings clean and dry. For shower or bath you will need to put a waterproof plastic bag (a bin bag usually does well) on your operated leg and seal it around your thigh with tape. Alternatively tightly wrap your knee with cling film.

Wound care:

• Keep your dressing clean and dry.

• Remove the bandage after 48 hours.

• Should your sticky dressing bleed through, change it to a clean one, leaving the steri-strips (adhesive strips sealing your wounds) intact.

Medications:

• You should resume taking your normal medications.

• Take painkillers as directed.

• When taking strong painkillers (Codeine, Tramadol, OxyContin, OxyNorm), you will need to watch out for constipation. Eat plenty of high fibre food and fruit and drink plenty of fluid.

Notify your Doctor if you:

• Develop a fever of 38 degrees or more that lasts 24 hours.

• Have numbness or tingling of your foot.

• Have profuse drainage from your wound.

• Have increased pain despite using painkillers.

• Develop increased swelling of your foot, coolness and loss of colour despite elevating and moving your ankle.

• Develop swelling and pain in your calf, back of the knee or your thigh.

• Develop sudden chest pain and shortness of breath (this could be a sign of pulmonary embolism – please go to the nearest Emergency Department.)

Rehabilitation plan

Rehabilitation after surgery for an ACL teat is a lengthy process. Return to sports and activities takes months. There are many variations of ACL rehabilitation, and the information provided here is simply an overview. Specific rehabilitation must focus on each individual athlete, and you must adhere to your own protocol. It is also important to note that timelines are a guide – progression depends on completion of one step, before advancing to the next step. The physiotherapist will give you home exercises – the success of the operation largely depends on how well you comply with the instruction and how hard you work.

The First Days:

Weeks 1-2:

Range of motion exercises can begin immediately after surgery. The initial focus is to regain full extension (the ability to fully straighten) of the knee. In general, flexion (ability to bend) is much easier to regain than extension.

You will work with the physiotherapist to work on gait training (walking), gentle strengthening, and aerobic work.

You can get on a stationary bicycle as soon as possible after surgery as this improves strength, motion and aerobic activity.

You can continue with icing (wrap a bag of frozen peas in a thick towel), elevation and pain killers and inflammatories if necessary, to control swelling.

Weeks 3-6:

Work is continued with the physiotherapist. As motion increases, emphasis is shifted to strengthening. Specifically, balance and proprioceptive exercises are very important.

Once normal motion has been achieved, some sport-specific activities can be stated. Before beginning these activities, motion must be near normal and the swelling in the knee gone.

Months 4-7:

Continued progression with sports specific activities. This phase of rehabilitation is often the most difficult, because you may have a knee that “feels” normal, but is not ready for the stresses of some sport activities.

Emphasis of rehabilitation should be on sport simulating activities. These will include figure-of-eight drills and plyometric, and over time will include sport drills. For example, a tennis player may start light hitting, a soccer player some controlled dribbling etc.

Return to sports:

Deciding when to return to unrestricted sports activities depends on a number of factors.

Depending on the type of sport, this is usually possible 6 -9 months after surgery .

Most importantly the decision must be based on your progression with physiotherapy.