ACL Frequently Asked Questions

When can I take a shower or bath?

Typically, after surgery your surgeon will check your wound at the I -week postop visit and let you know if you can get your knee wet. Prior to I week, you can take sponge baths, or you can shower with a large garbage bag over your leg with duct tape securing the bag at the top so the knee bandages don't get wet. Hint: Put a towel around the top of thigh at the area where you secure the bag with duct tape).

How long will I be on crutches?

Between I and 2 weeks unless otherwise instructed by your doctor. When you gain muscle control of your leg and feel secure, you can discontinue the crutches.

How long will I use the knee immobilizer?

Between 2 and 3 weeks, mostly to protect your leg in risky situations and until you gain the confidence and strength to go without it. Your therapist and/or surgeon will tell you when to stop using the immobilizer.

How long will I need pain medication?

Patients follow our Pain Management Protocol for 5 days after surgery, and most do not require any medication other than acetaminophen (Tylenol) after that.

How much pain will I have?

Pain varies from person to person, but most patients manage very well with our Pain Management Protocol. We have worked with a pain specialist anesthesiologist at Maine Medical Center to design the Protocol, and have used it successfully in over 1,500 ACL reconstruction patients.

Do I have to sleep on my back after surgery?

You may sleep in any position that is comfortable for you. (Hint: Try using several pillows to get a comfortable position)

How big will the incision be on my knee?

Approximately 3 to 4 inches long on the front of your knee for patella tendon grafts and 1 1/2-2 inches long on the inside front of your knee for hamstring grafts.

What is a Cryo/Cuff^® and how do I recharge it? How about the AutoChill?

The Cryo/Cuff^® is a self-contained compressive cold pack that can be recharged. It is used to control pain and swelling after knee, shoulder, and sometimes ankle surgery. Instructions for Cryo/Cuff^® use.

How many incisions will there be?

In addition to the incision on the front of your knee, there may be a 1/4-inch arthroscopic puncture wound and another 1/8-inch drain exit wound above the knee.

Why is my knee numb?

The numb area along the front and outside of your knee (and sometimes-lower leg) is the expected result of making the incision in the front of your knee. This incision interrupts small superficial skin nerves that supply the skin on the front and outside of the knee. This area of numbness shrinks in size over time, so that what starts out as a large area usually ends up as only a small area. This process can take six months to a year. This area of numbness is not harmful, but can be annoying. It occurs in everyone and is permanent. Also, if the operation takes two hours or more, some people experience a transient feeling of numbness in the whole leg which disappears in 24 to 48 hours.

Is the procedure arthroscopic?

Once the graft is obtained through a small incision, the rest of the procedure is done arthroscopically.

How long is the procedure?

Approximately 1- 1/2 to 2 hours. You will be spending approximately 2 hours in the Recovery Room after surgery

Is there any chance that I will wake up during the surgery?

No. The anesthesiologist is carefully monitoring you at all times.

Do the screws holding the graft in place need to be removed?

With both the patella tendon and hamstring grafts, the two bioabsorbable screws in your knee hold the graft in place while it is healing. They are very deep in your bone and cannot be felt by pressing on your knee from the outside. They do not need to be removed. It will take approximately two to three years for them to be fully absorbed. This slow absorption is not a problem since the ends of the graft are fully incorporated into the bone tunnels within two to three months.

Why is there a drain in my knee?

The drain helps prevent excessive swelling/bleeding that might otherwise require removal with a needle on the first day or two after surgery. The drain will be removed at your first postoperative visit.

How much activity can I do after surgery?

Initially, most of your activity is done in physical therapy. Swimming and exercise biking are two activities you can do early in rehabilitation, followed by the Stairmaster and treadmill later on. We ask you not to do any strenuous activity outside of physical therapy for approximately 12 weeks. That means no mowing lawns, etc., in the summer, and no snow blowing or shoveling in the winter.

It will take approximately six months for you to return to strenuous physical activity such as skiing, football, soccer, basketball, hiking, etc. You will be preparing for your return to sports by following the physical therapy protocol.

The reason you need to avoid strenuous physical activity is that the ACL graft, which is placed in your knee at the time of surgery, takes approximately six months to "re-vascularize" and become strong again. The graft actually gets weaker for a period of time after it is implanted. Even though you may feel no pain, have no swelling, and the knee feels stable prior to six months, lab studies have shown that the graft healing process takes six months or more. Once graft healing is complete, and you have regained full protective muscle strength in the leg, your surgeon will release you to return to full activities.

How much time off from work should I take?

One to two weeks for a desk-type job; up to three months for moderately physical work; up to six months for strenuous physical work.

Examples:
Student, secretary, computer operator: I to 2 weeks
Landscaper, airline baggage attendant: 2 - 3 months (with restricted work duties).
Construction worker: up to 4 - 6 months.

Many patients will choose to go back to work earlier on "light duty." Your surgeon will help you decide when it is appropriate.

When will I be able to drive?

You will be allowed to drive when you have discontinued: (1) pain medication, (2) the use of crutches and knee immobilizer, and have gained (3) good control of the knee that was reconstructed. This usually takes about two weeks, although patients having left knee surgery may be able to drive an automatic by one week post-op.