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FACT SHEET FOR PATIENTS AND FAMILIES ACL Reconstruction: Home Instructions What happens after ACL reconstruction surgery? After ACL reconstruction surgery, there’s a lot you can do to make sure you have a good outcome. At first you can help your wound heal by managing the pain and swelling. You’ll also need to start right away with rehabilitation exercises. These are exercises to help you regain range of motion in your knee, and to restore your sense of balance and control in your leg. Your surgeon replaced the damaged ACL with a new piece of tissue. You may need to wear a brace to keep your knee stable while it heals. For most patients, regaining full strength, balance, and control in the knee and leg takes several months. How fast and how well you recover depends in large part on how consistently and carefully you do your rehabilitation exercises. How do I care for myself at home? In the first days after surgery, your leg will be swollen and you will have a thick dressing covering your surgical wounds. Below are a few tips that will help you care for yourself and your incisions: Manage pain and swelling Care for your incision •• Take pain medication as prescribed. When you leave the hospital, your pain should be under good control. Your doctor may give you a prescription for pain medication to take at home. Take your pain medication as soon as you need it. Don’t wait for the pain to get too bad. Don’t take any pain medication that your doctor has not prescribed. Don’t drink alcohol while taking pain medication. •• Keep your dressings clean and dry. Your doctor will let you know when you can remove your dressings and when it’s okay to take a shower without worrying about getting your incisions wet. Do not soak in a tub, pool, or hot tub until your doctor says it’s okay. •• Elevate your leg. For the first two days, keep your leg elevated above your heart. Lie flat and use pillows to prop up your knee. •• Use ice as directed by your doctor to relieve pain and swelling. Your doctor may recommend a special ice machine. •• Wear your compression stockings (T.E.D. hose) as long as your doctor advises. Compression stockings help prevent blood clots. •• Watch for bleeding. You may have a small amount of bleeding from your surgical incisions. This is normal. •• Watch for signs of infection at the incision site (increased redness or swelling, pus, or fever over 101° F) and report them to your doctor. 1 Activity •• Take it easy the first day. You should rest on the day of surgery, other than getting up for the bathroom or to get meals or medication. •• Start your recovery exercises as soon as your doctor recommends. When you start your exercises depends on the extent of your injuries, the complexity of your repairs, and your physical condition. •• Avoid activities that cause pain or swelling to the knee. Examples include climbing stairs or standing or sitting for long periods. •• Use assistive devices as recommended. Assistive devices are tools to help you do what you need to do while you’re healing. After ACL rehabilitation, these usually include a knee brace and crutches. Using them just as your doctor recommends will help you heal faster. Return to sports. You can return to sports when you have no more pain or swelling, when your knee has full range of motion, and when your muscle strength and endurance are restored to normal. Your doctor needs to give written permission before you return to any sports or competition. Follow-up Your doctor will schedule an appointment to check your progress and answer your questions. Write down your questions and bring the list with you. When should I call the doctor? Watch for problems, and call your doctor if you experience any of the following: •• Your knee keeps bleeding (small spots might show on the bandages, but they shouldn’t spread). •• You have pain that you cannot control. Physical therapy •• Pus or foul-smelling liquid drains from your knee. Your doctor may recommend that you work with a physical therapist to help with your rehabilitation activities. A physical therapist can create and supervise a program of specific exercises to increase your flexibility, strength, and balance. Physical therapy also includes a variety of treatments to reduce scar tissue, promote healing, and help prevent future injuries. •• You have chills or a fever over 101° F. Returning to your normal activities The recovery period after ACL surgery, and what you can expect long-term, is different for every patient. It depends in part on your general physical condition, what you need to do, and other factors. •• You have nausea and vomiting that does not stop. •• Your knee continues to swell or feel numb, and elevating your leg or loosening your bandage doesn’t help. •• Your foot or ankle starts to change color. For more information Ask your doctor for these Intermountain fact sheets: FACT SHEET FOR PATIENTS AND FAMILIES FACT SHEET FOR PATIENTS AND FAMILIES How to Use Crutches Arthroscopic Knee Surgery Why should I use crutches? How should my crutches fit? What is it? If you have had an injury, a surgery, or procedure on your leg or foot, it will need time to heal. To help it heal, and to prevent pain, you need to keep all your weight off it. Using crutches will help you get around without putting any weight on your leg. You may be given forearm crutches (also called elbow crutches) or underarm crutches. In arthroscopic knee surgery, the surgeon inserts an arthroscope (a tube with a tiny camera) into your knee to explore and diagnose problems. The surgeon can then insert small tools through tiny openings to repair or remove damaged tissue. At first, using crutches may seem difficult. With a little training and practice, though, most people learn to walk safely with crutches. This fact sheet provides tips for using crutches safely. Forearm crutches How do I prepare to use crutches? Using crutches will be easier and safer if you prepare for success. Do these things before you start using crutches: • Remove tripping hazards. Make sure there are no throw rugs, electrical cords, spills, or clutter that might cause you to trip or fall. In this type of surgery, problems are diagnosed and treated without large incisions (cuts). This surgery usually does not involve a hospital stay. When standing up straight, • the cuff should be about 1 to 2 inches below where your elbow bends Arthroscopic surgery might be recommended if your knee continues to be painful, “catches” or gives way, or keeps swelling. Knee problems diagnosed and treated with arthroscopic surgery include: Use the buttons to adjust the length of the crutches. • Torn ligaments Return to work when your doctor advises. Many patients can return to office work within a week. If your work is physically strenuous and a light duty assignment is not available, you may need to be off work longer. • Get a back pack or fanny pack. Carry things in a hands-free bag or pack. Your hands will need to be on your crutches. • Wear shoes that fit well and stay on. Don’t wear loose sandals. Be especially careful to wear good shoes in wet or snowy weather. Cartilage Cartilage membrane Ligament Ligament Meniscus Meniscus • A damaged meniscus • Scar tissue or joint infections • Inflamed synovial membrane • Unexplained knee pain that doesn’t respond to other treatments Underarm crutches When standing up straight, Potential benefits • the underarm supports should fit about 2 inches below your armpits • Accurate diagnosis. The arthroscopic image helps your doctor get a better picture of what’s wrong with your knee. • your weight should rest on your hands, not on the underarm supports • Faster recovery than with traditional surgery. Recovery is usually faster than with surgery involving larger incisions. Use the bolts to adjust the length of the crutches and the height of the hand grips. • Less scarring. The incisions result in very small scars which are not easily noticed and don’t interfere with movement. You may have arthroscopic knee surgery to repair damage to these parts of your knee. Talking with your doctor about this procedure • Damaged or torn cartilage • Loose fragments of bone or cartilage • Arrange your household. If necessary, move furniture to make sure you’ll have plenty of room to get around. Put things you use often within easy reach. • Prepare your bathroom. Use hand rails, a raised toilet seat, and a seat in the shower or tub to help prevent falling in the bathroom. Wet surfaces in the bathroom can be very slippery. Synovial Synovial fluid fluid Synovial Synovial membrane Why do I need it? • the hand grip should hit about where your wrist bends. Your doctor will talk with you about your surgery, including the most common benefits, risks, and alternatives for this procedure. Other benefits and risks may apply in your unique medical situation. The conversation you have with your doctor is the most important part of learning about your surgery and what to expect. Potential risks and complications • Bleeding or Infection. With any surgery, there is a small risk of bleeding or developing a wound infection. Antibiotics and careful sterile techniques are used to prevent this. • Failure to relieve symptoms. Your surgeon will do everything possible to give you the best results. Even so, surgery may not relieve all your symptoms. Alternatives Arthroscopic knee surgery is usually done after non-surgical options have been tried. These can include: • Medications • Knee wraps or other supports • Physical therapy • Decrease in activity • Blood clots in the joint or bleeding into the joint. These problems are rare and treatable. 1 1 How to Use Crutches Arthroscopic Knee Surgery © 2012 Intermountain Healthcare. All rights reserved. The content presented here is for your information only. It is not a substitute for professional medical advice, and it should not be used to diagnose or treat a health problem or disease. Please consult your healthcare provider if you have any questions or concerns. More health information is available at intermountainhealthcare.org. Patient and Provider Publications 801.442.2963 fs275 - 04/12 Also available in Spanish. 2