You will have a compressive dressing on your operative leg, which is used to secure your post-operative dressing and to reduce swelling in the lower leg. This compressive dressing is very important in helping to prevent the formation of a blood clot and to minimize swelling and should be kept on until discontinued by your physician.
You will be using crutches when you first go home. If your surgery was for an isolated ACL tear, you will be able to weight bear as tolerated and wean yourself off crutches. However, if your surgery involved other structures, your physician will give you specific instructions about the use of crutches. Your physician will provide you a prescription(s) for pain management at home. Be sure to take medications with food.
The incision(s) need to remain dry for 3 days following surgery. After 3 days, you may get them wet in the shower, but should lightly pat the area dry with a towel and not rub them with the towel. The white steri-strips that are in place over your incisions will begin to curl up on the ends 5-10 days following your surgery. When they do, you can gently pull them off. A plastic chair in the shower may be useful to aid stability.
Ice packs or a cold water compression unit that circulates ice water around the knee joint should be used regularly for the first 72 hours. After that time, you will still find ice helpful in decreasing swelling and aiding comfort both before and after therapy or activity for twenty minutes at a time. Early knee motion begins in the recovery room to improve circulation and reduces joint stiffness. You will be instructed in range of motion exercises to perform at home. Your physician will assess your range of motion at your post-op appointment and discuss beginning physical therapy at that time.
Signs of concern: It is rare to have an infection develop following an ACL repair, but you should always be vigilant for signs of infection. Should you run a fever following surgery, it is most often due to the effects of anesthesia. Be sure that you are doing deep breathing followed by coughing ten times every hour for 24 hours following your surgery. You should also be sure to drink plenty of fluids. Should you develop a fever greater than 100.5 that persists for more than 24 hours despite doing all your breathing exercises, please call the office. Should you develop any calf pain behind your calf, be sure to contact the office. Swelling and discoloration below your knee progressing to your ankle is normal following knee surgery.
First post-operative appointment: You should call your physician's office and schedule your first post-op appointment to see your physician for 7-10 days following the date of your surgery.
Physical therapy and rehabilitation: Your rehabilitation will begin immediately following your surgery. In the recovery room, you will be instructed in isometric contractions of the quadriceps (front thigh muscle) and hamstrings (back of the thigh muscles). You will also by instructed in ankle pumps (moving the foot up and down), to improve calf circulation and reduce the potential for developing blood clots in the calf. Your physician will check your status and assess your range of motion at your first post-op appointment. At that time, he will discuss with you plans for physical therapy. You can expect to initially go to physical therapy 2-3 times a week for the first month. It is extremely important that you adhere to the protocol set by your physician with your physical therapist in terms of what exercises and activities you are permitted to do. The physical therapist will be an important part of your post-operative care and rehabilitation and will work with your physician to promote your recovery. Your physician will discuss your progress at each appointment and advance your activity based on his assessment.