Preparing for ACL Surgery
What do I need to do to prepare for surgery?
My staff will work with your to set up the surgery through your insurance company and will instruct you in any matters that you may need to take care of concerning your insurance paperwork.
Prior to surgery you may be asked to perform some exercises at home or with a physical therapist. These exercises prepare the knee for surgery by decreasing swelling, increasing motion and maximizing the strength of your leg.
A few weeks prior to surgery, you will need several medical tests, which are done on an outpatient basis. Most patients need blood tests and urinalysis. If you are over 35, you may require a chest X-Ray and EKG. You will also need to see your internist or family doctor to have your medical history checked and receive clearance for the procedure. Again, the office staff will work closely with you in arranging these tests.
What type of anesthesia is used?
Spinal or general anesthesia can be used. Many times a nerve block is also used to help with pain control. An anesthesiologist is always present if there is a need for further sedation or pain control. Prior to surgery, an anesthesiologist will discuss with you the various options and answer your questions.
How long will I be in the hospital?
Most people are able to have surgery and go home the same day. Several factors, including your age, health status, other damage to the knee and the side effects of anesthesia, may affect your ability to go home the same day of surgery.
What happens the day of surgery?
The day before surgery you will be told what time to report to the hospital on the day of your procedure. It is very important to arrive on time. You will be admitted to the hospital and taken to a pre-operative area where you will be prepared for your surgery. You will see your surgeon and meet the nurses and anesthesiologist the day of surgery. Then, you will be taken to the operating room. After the operation, you will be taken to the recovery room. Here the staff will monitor that the effects of anesthesia are wearing off properly and they will provide you with medication for any pain you are experiencing. You will be given post-surgery instructions to follow at home and then discharged after you have adequately recovered.
How should I care for my knee after surgery?
Prior to your discharge from the hospital you will be given specific instructions on how to care for your knee. It is important to follow these instructions. In general, you can expect the following:
Brace: In most cases, you will have a brace on your knee. You should leave it on unless you are instructed to take it off by my office. When walking, the brace should be locked in the straight position. You can unlock it (so it will bend) or remove it as needed for exercise with your physical therapist.
Walking: You will have crutches to assist you with walking. You may put weight on your foot as tolerated as soon as possible after the surgery, unless instructed otherwise. You must have the brace on and locked straight when walking. Most people are able to get rid of their crutches in 2-3 weeks, but the brace must stay on.
Ice and compression machine: You may have an ice and compression machine delivered to your home. You will be instructed in its use. The machine is not used in all cases as coverage may depend on your insurance.
Returning to work or school: Most people are able to return to their jobs or school within 1-2 weeks. The exception to this is for people who have strenuous jobs that require them to be on their feet a lot, lifting objects, climbing or driving.
What will rehabilitation involve?
Your rehabilitation will be based on strict guidelines that have been developed over many years. You will need physical therapy for a few months to regain motion, strength and agility. In general, Dr. Dhar uses an accelerated protocol, which is based on several goals including early motion and weight-bearing, and regaining control of the leg muscles as soon as possible
You will start out with very specific exercises and will be permitted to do more as you recover. Most people can expect at least a 6-month period before they are allowed to return to full activity. Overall, advances in diagnostic capabilities, surgical techniques and rehabilitation have made ACL injuries a highly manageable condition.