ACL Reconstruction PostOp Protocol

Brett Young, M.D., Joe McCormick, M.D., Chris Prato, M.D., Daniel Metz, M.D.

1531 S. Madison Street, Appleton, WI 54915

Initial Care: Ice and elevation along with pain medication are the keys to initial pain management. You will be given a prescription for Vicodin© or Percocet© tablets. These medications contain Tylenol© and a mild narcotic, and can be used every four hours as needed for pain. DO NOT use additional Tylenol© products. Ibuprofen (Motrin©) can be taken every six hours as a supplement. You will also have a “pain pump” that will deliver pain medication directly into the joint. This pump is designed to provide 48 hours of pain relief and reduce the amount of oral pain medication needed. It should be removed on the second postoperative day during the dressing change. You will be sent home with crutches walking in a knee immobilizer brace as tolerated.

Ice Usage: Another item that will be useful in controlling postoperative swelling and pain is the application of ice. It is very important that the surgical dressing be kept dry. You may choose to use leak-proof Ziploc© bags with ice, frozen peas or corn, or, if paid for by your insurance, an ice water delivery system. Apply the ice to both the front and back of your knee for twenty minutes out of the hour (20 minutes on, 40 minutes off). Ice should never be placed directly on the skin.

Dressing Changes: Remove the entire dressing down to the butterfly strips on the second postoperative day. It is expected that there will be dried blood on the dressing, and sometimes new bleeding starts if the dressing is stuck to the skin. Do not worry. You may clean the surrounding skin with hydrogen peroxide solution prior to replacing the dressing. Remove your “pain pump” catheter by simply sliding the tubing out of the skin, applying a few minutes of direct pressure on the removal site to control any bleeding. Place band-aids and/or 4x4 gauze pads over the wound(s) and cover with an ACE bandage. It is common to have bruising and skin discoloration behind the knee and down the calf to the foot. Do not be alarmed; be sure the ACE wrap is not too tight, as this will increase both pain and swelling. Keep the wound dry for the first week by taping plastic over the dressing when showering (Do not attempt a bath). The sutures will be removed at the first office visit.

Office Appointment: Your first office appointment following surgery will be arranged by the same day surgery center for approximately 7-10 days postop. Call the Affinity Orthopaedics & Sports Medicine office at (920) 996-3700 the following day to confirm your appointment.

Ambulation: It is expected that you will use crutches and wear your knee immobilizer when upright. You may place weight on the operated leg as tolerated. You should not be in the upright position for more than fifteen minutes at a time since this will only increase swelling and slow down the rehabilitation process. Remember ice and elevation.

Knee Extension: You should place a rolled up towel beneath the heel and gently push the knee into the bed. DO NOT place a pillow beneath your knee while sleeping. This is very important to achieving full knee extension. While performing this maneuver, the patient should attempt to hold a quadriceps contraction for three seconds, 15-20 times. This exercise becomes isometric strengthening.

Physical Therapy: Formal physical therapy will need to be arranged by your physician, but is not begun until after the first office visit.

Emergencies: Please call Affinity Orthopaedics & Sports Medicine at (920) 996-3700. After hours, an Orthopaedic Surgeon is available by having the Affinity operator page the on-call orthopaedic physician. Please call the office sooner if your calf becomes excessively swollen or painful after the second postoperative day, or for any further questions.

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