ACL Reconstruction FAQ

An ACL reconstruction is recommended for people with an ACL injury who are very active, people who also have injuries to other structures in the knee or people who continue to have pain and instability after non-operative treatment. Like any surgery, there are risks involved with this procedure. Some of these risks can be serious. You should discuss your options carefully with your surgeon so that together, you can decide on a treatment plan that is right for you

• The better the knee can move and stronger the muscles are around the knee – the better your recovery will be. Physiotherapy is strongly recommended before surgery.
• Once you and your surgeon have decided that an ACL reconstruction is the right decision for you, a plan will be discussed with you regarding your usual medications as some of these medicines (like blood thinners or blood pressure tablets) may need to be stopped before your surgery
• For people with other health conditions, we may arrange for the anaesthetist to see you before your surgery to make sure your surgery is as safe as possible
• We know that smoking increases the risks associated before surgery. We recommend that patients stop smoking, both before and after the operation, to reduce the risk of a complication occurring

There are several steps to take to make your operation as safe and smooth as possible.

• It is very important not to have anything to eat or from 6 hours before your operation although you can have small sips water up until 2 hours beforehand. This is because some of the medicines used as part of your anaesthetic may cause the stomach to relax and if your stomach is not empty, the contents may move into the lungs and cause serious problems with your breathing
• When you arrive at the hospital, our staff will help you change into a hospital gown and will give you stockings to wear to reduce the risk of blood clot
• Your surgeon and the anaesthetist will see you before your surgery to complete your consent form and answer any questions you might have. Your surgeon will also draw an arrow on your leg to confirm the operation and side to be operated on. This is a standard part of our safety checklist for every operation
• At several points before your operation, your identity and surgery will be confirmed along with other important medical information (such as allergies). This is another standard part of our safety checklist for every operation
• When it is time for your surgery, you will be taken through to the operating room. Most people find this a little daunting as there are a lot of people in the room and a lot of specialist equipment. Just remember, everyone in the room is there to look after you, answer your questions and make you as comfortable as possible
• Most patients will require an IV line (drip) to be placed to administer your anaesthetic

• When your surgery is complete, you will spend some time in the recovery room (PACU) where you are looked after by a specialist team before being transferred to the ward or allowed to go home.
• You will be given regular pain relief medication but it is important to let the staff know if you have pain, nausea or other concerns so that we can keep you safe and comfortable
• You will be shown how to use your crutches when you are comfortable and have recovered adequately from your anaesthetic
• Most people will be able to go home the same day of their surgery
• You will be given follow-up appointment details and numbers to call if you have any concerns.

• Someone should be available to stay with you and provide additional support if needed when you return home from the hospital. This is particularly important in the first 24 hours after your surgery
• You will haveseveral small waterproof dressings on your knee which should stay in place until you see your surgeon, usually two to three weeks after your operation
• There will be a bandage over the top of the dressings. This can come off after 48 hours
• You are usually allowed to walk on your leg. Most people need crutches to help for 1-2 weeks.
• You will be given more detailed instructions on what to do before you leave hospital.
• It is important to see the physiotherapist and follow the program carefully to ensure that your operation has the best chance of success. This will be discussed at your first follow-up appointment at approximately 2-3 weeks after the operation.

• Everyone is different but most people are able to resume normal activities by 6 weeks
• Most people are advised to use crutches for a period after their operation for additional support
• You will not be allowed to return to collision sports or pivoting sports for 9-12 months following surgery (this is to allow the graft to heal and to make sure your muscles and reactions are ready)

• Provided your pain is well controlled and you have recovered adequately from your anaesthetic, you are able to walk with crutches the same day

• Generally, we advise that patients may not drive in the first 4-6 weeks after an ACL reconstruction. After this period, it is important to be sure you could make an emergency stop if required before resuming driving. We also recommend checking with your car insurance provider to ensure they do not have rules regarding surgery and driving. If you do not comply with these rules, they may not cover you in the event of an accident

• This depends on the type of work you do. People with a sedentary job may feel they are able to return to work soon after surgery. If your job is very active, you may require 6 weeks or longer before return to work is advised. If your work involves dangerous activities, you may need to be off for 12 weeks.
• You should talk to your surgeon about what is right for you.

• This might be different for each patient. It depends on a number of factors including the surgery and the type of sport however, it would be normal to be advised to avoid sports and training for at least 12 weeks. If you play a collision or pivoting sport (rugby, netball, football plus others) you will not be allowed to return to these sports for 9-12 months following surgery (this is to allow the graft to heal and to make sure your muscles and reactions are ready)
• You should discuss this with your surgeon before agreeing to surgery.

• Immediately after your surgery, you will have a bandage which is not waterproof. This is usually removed after two days and the dressings underneath are waterproof (but you can’t soak it in a bath or pool).
• Your waterproof dressing should stay in place until you see your surgeon to check your wound, two to three weeks after your surgery

• You will receive information about your next appointment before you leave the hospital
• You will see your surgeon two to three weeks after your surgery to check your wound and then again 6 weeks after your operation

• If you have chest pain, shortness of breath or other serious problems, you should seek emergency attention without delay
• If you are there is a problem with your wound or if you have other concerns about your progress, you should contact the hospital or your surgeon who will advise you on the best course of action