Medications: (Prescription given to patient)
- Oxycodone/acetaminophen –10 mg/325 (Percocet®)
Take as directed for pain (with food) - Hydrocodone/acetaminophen – 5 mg/325 (Norco®)
Take as directed for pain (with food) - Oxycodone Hydrochloride –10 mg (OxyContin®)
Take as directed for pain (with food) - Oxycodone – 5mg
Take as directed for pain (with food) - Promethazine (Phenergan®)
Take as directed for nausea - Zolpidem (Ambien®)
Take as directed for sleep - Ondansetron (Zofran®)
Take as directed for nausea
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Diet: Advance diet as tolerated.
Constipation is common with the use of pain medication. You can ward off constipation by increasing both dietary fiber and water intake. One tablespoon of milk of magnesia is effective and can be taken once or twice daily.
Activity:
If you received a peripheral nerve block, you must be non-weight bearing on the operative leg until block wears off.
Dressings: Keep dressings dry and intact with knee immobilizer in place for 3 days unless otherwise instructed by your doctor.
Ice:
Apply an ice pack to the knee to minimize pain and swelling.
Use Cryo/Cuff®, PolarCare™, or Game Ready® as directed (see attached instruction sheet).
Office Appointment: If you do not already have a post–op appointment, please call our office to make one.
Call your surgeon if
You develop a fever above 101 degrees.
The pain is severe and unrelieved with medication.
You have any questions or problems.
Anesthesia:
The subtle effects of general anesthesia or sedation with regional/local anesthesia can last more than 24 hours. Rest on the day of surgery. Although you may feel normal, your reflexes and mental ability may be impaired. You may feel dizzy, lightheaded, or sleepy for 24 hours or longer. Do not consume alcohol, drive, operate machinery, or make important personal or business decisions for 24 hours. After a general anesthetic, it is normal to feel generalized aching and sore muscles for 24 hours. A sore throat may occur.
ACL Reconstruction Post-Surgery FAQ
Weight Bearing
How much weight should I put on my leg?
All of it. One of the great advantages of knee arthroscopy is that you may start walking on the operated knee right away. If you have received a peripheral nerve block, you must be non-weight bearing on the operative leg until block wears off.
Do I need to use crutches? For how long?
Many surgeons give their patients crutches after surgery while many do not. It is difficult to predict who may or may not need them. Use the crutches as needed. This will likely be if you feel unsteady or pain while you walk. Some patients need crutches for a few days after surgery to help support them while walking while others never use them at all. If you need them, use them.
Knee Brace
Do I really need to wear this horrible, big uncomfortable brace?
Unfortunately, yes. The brace is necessary to protect the new ligament. The brace will help keep your knee safe while you walk right away.
Even when I sleep?
In the beginning, yes.
For how long?
The brace will be worn for up to 6 weeks after surgery. Initially, the brace will be locked straight for walking. When you are off the crutches and walking with minimal difficulty, we will then start to unlock the brace. The brace has hinges on the side that will allow us to slowly increase the amount of bending. Once you can walk in the brace unlocked (i.e., full motion), we will then discontinue the brace.
Ice
How much ice and for how long?
There is no right or wrong answer to this question.
Ice helps with the swelling and can help to decrease pain after surgery. For the first few days after your surgery, “the more, the better.” Ice approximately 30 minutes 3–5 times per day. The first night and first day following surgery, you should ice as much as possible.
Will the ice penetrate through the dressing?
Yes, it will. It might not feel like it, but it does.
Will the moisture from the ice get my incision wet?
No. There are many layers under the tape.
Some patients prefer PolarCare™ or Game Ready® coolers. Insurance does not reimburse for them unfortunately.
Dressing/Bandage
My dressing fell off; what should I do?
Don’t worry; due to the shape of our legs, this does happen. You may want to try to pull it back into place. You may want to unwrap the ace wrap bandage and reapply it. If it has been a couple of days, you may remove the dressing and cover the incisions with large band-aids, then reapply the ace wrap. The ace wrap will help keep the brace from chafing your skin. Prior to this, please wash your hands, and don’t mess with the incisions.
My appointment is not for over a week; do I need to keep the dressing on?
We would like the operative dressing to be left in place for the first 3 days. After that, you may follow the above instructions. We recommend removing the dressing, placing large band-aids over the incisions, and then reapplying the ace wrap.
When can I shower?
You can shower like normal after 3 days. Until then, you will need to cover the dressing and brace to keep it dry while in the shower. There are a variety of ways to do this. We suggest simply wrapping the leg with plastic wrap (e.g., Handi-Wrap, etc.) above and below the dressing. You may also use a plastic bag with tape or a rubber band.
Pain
The pain medicine doesn’t last long enough, but the bottle says “take every 3–4 hours.” Can I take it more often?
People vary in how much and how often they need to take pain medicine. Pain pills take a good 30–45 minutes to be absorbed and start giving pain relief. We suggest trying to anticipate and stay ahead of the pain for the first several days after surgery.
Don’t be a clock-watcher. If the pain medicine only lasts 2.5 hours instead of 3–4 hours like the bottle says, simply take it a little more often. If you are in pain, take medicine. Don’t suffer. Some people never take a pain pill after surgery and other patients take them for a week or so. We are all different. If you have a history of drug or alcohol use, you will probably find that you will require more medications.
Can I take Tylenol® or ibuprofen (Advil®/Motrin®)?
Pain medicine is mixed with Tylenol® so do not take any additional Tylenol®. You may take ibuprofen or naproxen along with the prescribed pain medication.
Other FAQ
When do I need to see my doctor in the office?
Our surgery scheduler usually makes your first appointment in advance. You should have received an appointment card in your pre-op packet. If you don’t know when that appointment time is, please call the office to confirm the day and time. Your first appointment is probably a week or so after your surgery. We have an open-door policy: if you have any concerns or problems before your first appointment, just call the office at (415) 492-1600 or use the patient portal in the electronic medical record and someone will see you.
When can I start physical therapy?
You may start the week following surgery. If you have already seen a therapist before surgery or know where we plan to start therapy after surgery, you should set up appointments in advance. Most of the therapy places are very busy, so scheduling your appointments in advance will allow you more choice of times to attend.
Can I drive? When?
While you are on pain medication, do not drive.
When can I return to work?
It depends on the type of job you have. If you do mainly desk work or sedentary work, you may return when you feel up to it. Most people return within 3–5 days. If you have a physical/labor intensive job, then expect to take at least a couple of weeks off. We will then discuss it as you progress postoperatively. Most people return to regular activities anywhere between 4–8 weeks after surgery. Sports and high-level rotational activities can take months before you are safe to perform those activities. This is usually sport-dependent and depends on your level of activity (e.g., high school, recreational, college, professional).
Remember that you will have little aches and pains in different parts of your body after surgery.
If you have questions or concerns, please call our office. If it is after hours or on the weekend, follow the instructions on the answering service to leave your doctor a message. Someone will call you back as soon as possible.
If you have a history of serious medical problems and start having difficulty breathing, chest pain, etc., please call our office and/or your primary care doctor, present to a local emergency room, or call 9-1-1.