Anterior Cruciate Ligament Tears and Their Treatment: arthroscopic and minimally-invasive surgery for ACL reconstruction
Edited By: Christopher J. Wahl, M.D., Suzanne L. Slaney, PA-C, ATC, MMS
Last updated Friday, October 20, 2006
Recovering from surgeryPain and pain management The recovery of comfort and function following an
arthroscopic ACL reconstruction continues over a few months. Initially, the knee must be protected with a
postoperative brace, to prevent overuse or stressing the repair while the knee
heals. Additionally, a very strict
rehabilitation program will be initiated to provide the most favorable
opportunity to heal without complications.
Ironically, many patients who undergo this procedure will feel very
comfortable long before the definitive healing has taken place, so strict
adherence to the postoperative activity restrictions is critical.
Immediately postoperatively, the patient is given strong
medications to help with the discomfort of swelling and the work of the
surgery. Patients are discharged home
with a prescription for oral pain medications. Use of medications Immediately postoperatively, pain medications are given
through an intravenous (IV) line. The
individual will be sent home with oral medication that is to be taken for pain
control. Oral pain medications are
rarely required after the first few weeks following the procedure.Effectiveness of medications Pain medications are very powerful and effective. The proper use of these agents lies in
balancing their pain-relieving effects and their other, less desirable
effects. Good pain control is an
important part of appropriate postoperative management.Important side effects Pain medications (taken orally or through the IV) can
cause drowsiness, slowness of breathing, nausea, vomiting, itching, allergic
reactions, or difficulties in emptying the bladder or bowel. Patients who have been on pain medications
for a long time prior to surgery may find that the usual doses of pain
medication are less effective. For some
individuals, balancing the benefits and side effects of medications is
challenging. Patients should notify
their surgeon if they have had previous difficulties with pain medications or
pain control.Hospital stay Most patients do not require an overnight stay at the
hospital after an ACL reconstruction.
Generally, a person will spend one to two hours in the recovery room
until the anesthetic medication has worn off.
When the patient is ready for discharge they will be
instructed on the following:
- What home exercises are appropriate and how
often to do them
- How to take the prescribed medications
- When and how to remove the postoperative
dressing
- How to use the postoperative knee brace
- How to care for the operative knee and incisions
- How to recognized potential problems, and what
is normal and abnormal
- Who to call if there are any concerns or
questions
Recovery and rehabilitation in the hospital The first two weeks after an arthroscopic ACL
reconstruction are dedicated to controlling pain and inflammation, and resting.
Because fluid is used to expand the knee joint during
arthroscopic procedures, the knee is frequently swollen for a few days
following surgery. Also, the incisions
will “weep” fluid for a couple of days postoperatively, and the dressing can
become damp.
Generally,
the patient can shower on the fifth postoperative day as long as the incisions
are no longer draining. The area should
be protected with plastic wrap and tape and should not be soaked in water. The patient should keep the incisions as dry
as possible at all times until the sutures are removed.
The patient will be given a hinged knee brace. Unless otherwise directed by the surgeon, the
patient will be able to bear as much weight as tolerated on the operative leg
with the use of crutches and the brace.
It is recommended to not engage in prolonged periods of standing,
walking, or sitting over the first 7 to 10 days following surgery to eliminate
and prevent swelling, pain, and stiffness.
In order to control pain and inflammation it is advised to
use a Cryocuff or ice pack for 20 minutes every hour until your first
post-operative visit, then as needed for pain relief. In addition,
compression with an ace wrap
that is not wrapped too tightly or thickly will provide relief.
Finally, elevating the operative leg above the patient’s heart as much
as
possible for the first 3 to 4 days will help with swelling. It is
strongly advised to elevate the leg
with a pillow under the calf or foot, NOT under the knee.
For the first 2 weeks, a home program of rest and gentle
range of motion and muscle control exercises are recommended. Typically at 14 days postoperatively a
prescription for outpatient physical therapy will be provided and the
progressive return to normal function will begin. Surgery for Anterior cruciate ligament - ACL - tear at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-543-1552 or 425-646-7777 to make an appointment.
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