Houston Orthopedic Surgeon for Knee Injury or Shoulder Injury

Post-Operative Instructions (ACL)

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION POST-OP INSTRUCTIONS

ACTIVITY: Upon discharge from the hospital, it is important that you continue using the Continuous Passive Motion (CPM) machine. You will need to stay in the machine 8-10 hours a day in 2-hour blocks of time, in addition to sleeping in the machine at night. You will need to use this machine for approximately one week, until your knee easily bends to 90°. Do not go beyond 90° in the machine. When you are not in the machine, you may be up and active, ambulating with your crutches and the brace. You may remove the brace for sleeping. While walking, you may bear as much weight as is comfortable, as long as you are using the crutches and the brace and not limping.

WOUND CARE: You have a gauze dressing under a stocking. The dressing is sterile, so please do not remove it unless it becomes saturated with drainage from your knee. It is normal to see pinkish-red fluid on the bandage. When I do the surgery I inflate your knee with fluid so I can see, and some of this fluid gets absorbed by the tissues around the knee. It will leak out onto the bandage. So, don’t be alarmed! But, if the bandage becomes saturated, we will need to change the gauze. I would prefer that we change it for you at your post-op visit, but if this is not possible you may do so by removing the outer layer of the gauze, leaving the inner layer alone. Use the stocking to hold the gauze in place. You may change these as frequently as necessary. The stocking will hold the gauze in place. You don’t need a wrap or tape. Keep the stocking on at all times except for washing. This helps prevent swelling in the knee and calf, as well as blood clots. Sometimes an ice cuff will be applied to your knee. Use the cuff around the clock for two days, then 3-6 times a day for at least 20 minutes for 1 week. Also, use the ice cuff after exercising. Use of the ice cuff will minimize swelling and reduce discomfort. Keep the knee dry until you are seen in the office. If your insurance company does not cover the ice cuff, you may use ice bags instead.

MEDICATIONS: You have been discharged with a prescription for pain medicine. Use this only as necessary for pain. For mild pain, take Extra-Strength Tylenol. If you need more pain medication, please call the office during office hours. Pain medications cannot be refilled on weekends. You can take the Vicodin (hydrocodone) and Toradol (Ketorolac) as they do not interact.

EXERCISES: In addition to the Continuous Passive Motion machine as described above, you will need to continue with exercises on your own. It is important that every 2 hours you perform the passive stretching exercise by elevating the heel on a pillow and letting gravity extend (straighten) the knee. This can be done as you have been performing in the hospital by stopping the Continuous Passive Motion machine in extension and placing a pillow beneath the heel. This may also be performed at other times during the day, such as sitting on the couch and placing the heel on the armrest, again leaving the knee free so that gravity can straighten this as much as possible. You cannot do any damage to the graft or pull anything loose by letting gravity completely straighten the knee. You are to start outpatient physical therapy within a few days. There are a few facilities Dr. Lintner prefers, discuss this with our staff to choose the best one for you. You are to continue on a daily basis until seen back for your first postoperative visit at which time your progress will be evaluated and the frequency of your outpatient physical therapy will be adjusted.

OFFICE FOLLOW-UP: Call the appointment desk to arrange for your first postoperative visit which should be approximately 7-10 days after your surgery, unless otherwise instructed, at 713-441-3560. John Roker, my Physicians Assistant, will probably see you on your first postoperative visit to check your incisions, remove sutures, obtain x-rays, and begin therapy if needed.

GENERAL CARE: It is important that you continue to be active. You should also try to cough and breathe deeply at home to minimize any temperature elevation that may result from mucus secretions in the lungs. Obviously, should you sustain an elevated temperature, begin to experience increased pain in the knee, or show signs of redness or abnormal wound healing, contact the office immediately at 713-441-3560.

Revised December 2004
Dr. David Lintner - Houston Orthopedic Surgeon