ACL RECONSTRUCTION

James Davitt MD

THE NUMBER TO CALL FOR ANY PROBLEMS OR QUESTIONS IS: 503-214-5200

ANESTHESIA:

- You will feel a little off for a day or two after the anesthetic. During that time you should not drink alcoholic beverages, make any important decisions or engage in any potentially hazardous activities. It is very common to be slightly nauseated and you should start with a light, low fat diet until your appetite comes back.

BATHING AND WOUND CARE:

-The knee will have a dressing over it that is held on with an ace bandage. A brace will be put on over the ace bandage. It is common to have some blood show through on the dressing. The dressing will be changed at your first office appointment. After that you may shower and get the wound wet if the wound is dry. You do not need to put a new dressing on if the wound is dry, but you should keep the brace on for the first two to three weeks to keep swelling down. You should not immerse the knee in a bath or hot tub until the wounds are healed over.

PAIN MANAGEMENT

-A long acting local anesthetic is injected into the knee after surgery and usually wears off 6-12 hours later. As it wears off your knee will begin to hurt more.

-The interval for taking pain medication, as noted on the bottle, is a minimum interval. That is, you should not take the medication more frequently than that. You may, and should take the medication less often than on the prescription if you are not in pain.

-You may have been prescribed a long acting narcotic pain medication that is taken twice a day. This is designed to give you a steady level of pain medication over the first day or two when the knee is the most uncomfortable. You may take the short acting narcotic in addition if you are still having pain.

-You have been prescribed a short acting narcotic pain medication. This medication should be taken to relieve pain, not to prevent it. You should not set your alarm clock to remind you to take your pain medicine, nor should you take it on a set schedule even if you are not hurting, as this can result in overdosing of the medication.

-If you do not have trouble with ulcers or stomach pain, and if you do not have kidney problems, you may also take an anti-inflammatory medication in addition to or instead of the narcotic medicine. . An average sized adult may take three 200 mg ibuprofen (Advil/Motrin) every 8 hours, or Aleve two tablets twice a day, with food for a period of two weeks.

ICE AND ELEVATION:

-You should go directly home from the hospital and lie down with your knee elevated so that it is above your heart.

-You should put ice packs on the knee and change them when they get warm. You will not feel much of the cold will get through the dressing but it will still help with the swelling as well as decrease pain.

- Elevationis the best way to decrease your pain and swelling. After surgery the circulation in your leg takes time to return to normal. If you leg is left below your heart and not moving for substantial periods of time then blood pools in the leg and can potentially lead to blood clots, which can be very serious. Ankle pumps should be done at least 50 times an hour while you are awake to keep the blood flowing in your leg.

WEIGHT BEARING AND CRUTCHES

- Unless specifically instructed otherwise, you may bear weight on your leg as tolerated. That means that if you are able to put weight on the leg with minimal discomfort and with good control of the leg it is ok to do so. You should use crutches until cleared by physical therapy in two to three weeks.

RANGE OF MOTION

-The knee brace keeps your knee straight. It will be removed at your first office visit. Even though the brace is locked straight the knee can still bend a little bit in the brace, so you should work on passive extension exercises for 10 minutes out of each hour while you are awake. You can do this by taking all pillows out from under your knee and placing them under your heel so that your knee is not held up into a bent position. This is the most important exercise for you to do. If you do nothing else and are able to get your knee straight at your first therapy visit you will do very well. You will be using the immobilizer for 2-3 weeks.

DRIVING

- After you are able to walk without crutches and without limping your leg is mechanically able to perform the tasks associated with normal driving. It takes about six weeks before the speed needed to do things like a panic stop return to near normal.

-I can tell you if you should be mechanically able to do the things needed to drive. I cannot tell you what would happen if you did something that hurt and led to your losing concentration etc. You must make your own determination as to whether you are safe to drive.

-You cannot drive if you are taking narcotic pain medication.

FOLLOW UP

-You should have had a follow up appt arranged for 6-8 days post op when your surgery was scheduled. If you do not know when it is please call the office to find out.

- You should also have a physical therapy appt arranged to follow your office visit that day or the following day. If you do not know when it is please call the office or the therapist.

SOME REASONS TO CALL

- Fever greater than 101.5 (it is very common to have a low grade fever the first night or two after surgery).

-Redness or swelling that is spreading from the edges of the incision.

-Pain that is out of control or worsening and not relieved by relieved by rest, elevation, and pain medication.

-Chest pain or shortness of breath.

OFFICE 503-214-5200

IF YOU THINK THAT YOU HAVE AN URGENT PROBLEM THAT NEEDS TO BE SEEN RIGHT AWAY THEN GO TO THE EMERGENCY ROOM.