Post-Operative guide for ACL Reconstruction with

L. Ryan Smart, MD
Knee Arthroscopy
Post-op Packet
Post-op Reference Sheet
Physical Therapy Prescription
Exercise Sheet
Surgical Pictures
SOS Fayetteville
4115 Medical Center Drive, Fayetteville, NY 13066
Tel: 315-329-7600, Fax: 315-329-7608
SOS Liverpool
5100 West Taft Road, Liverpool, NY 13088
Tel: 315-452-2120, Fax: 315-452-2118
L. Ryan Smart, MD
Patient Post-op Reference Sheet:
Knee Arthroscopy
Pain Control and Ice
A pain medication prescription will be provided prior to discharge.
You may take the prescribed medication as directed.
You should expect to experience minimal to moderate knee discomfort for several days and even weeks
following the surgery.
Patients often only need prescription narcotics for a few days following the surgery and then switch to over-the
counter medications such as Tylenol or Ibuprofen.
Ice bags and elevation should be utilized to decrease swelling and pain. Ice should be applied to the knee up to
three times a day for 20 minutes until swelling subsides
Wound Care
If there is bleeding through the bandage, reinforce it with additional dressings for the first 24 hours.
After 48 hours, remove the bandage, if the incisions are dry (no bleeding) place band aids. If the knee is still
bleeding, place new sterile dressings over the incisions and change to Band-Aids after an additional 24 hours
Showering is acceptable after 48 hours.
Do not submerge or scrub the knee
Rehabilitation/ General Post-op Care
You will be able to put as much weight as tolerated on your leg utilizing crutches
Home physical therapy may all you need to do. Sometimes formal PT is needed.
Take one 325 mg (full strength) aspirin daily for 14 days (unless otherwise instructed or allergic) to prevent
blood clots.
First post-op appointment is 7-10 days for suture removal
You may drive once you establish control of you operative extremity. If your right knee was operated on, this
may take approximately 3-5 days to achieve. You may not drive under influence of pain medication.
Plan at least 2-3 days away from work or school. Utilize this time to decrease swelling and participate in your
home exercise program. You may be able to resume work once the pain and swelling resolves (this varies
based on job activity).
Sample Pictures for Education Purposes
Grades of Osteoarthrits
Types of Meniscal Tears
(Remove from packet and bring to your initial physical therapy appointment.)
L. Ryan Smart, MD
Physical Therapy Prescription
Patient Name: _________________________________________________
Diagnosis: ____________________________________________________
Progressive range of motion, modalities for edema and pain
reduction, progressive resistive exercise
Frequency: 2-3x a week
Physical Therapy Facility
SOS Fayetteville
4115 Medical Center Drive, Fayetteville, NY 13066
Tel: 315-329-7600, Fax: 315-329-7608
SOS Liverpool
5100 West Taft Road, Liverpool, NY 13088
Tel: 315-452-2120, Fax: 315-452-2118
L. Ryan Smart, MD
General Post-op Rehabilitation Guide
Phase 1 (Week 0-1):
Goals: Minimize effusion, Full range of motion, Initiate CKC exercises, Normalize gait
pattern/balance - independent mobility and proprioception abilities
Treatment plan:
1) Swelling Control with ice and compression wrap
2) Progress towards full range of motion
3) Initiate quadriceps and hamstring muscle activation and general leg control
 Quad setting, SLR, heel slides, isometric hamstring/quadriceps contraction
 Ankle pumps
4) WBAT with crutches
5) Electrical stimulation to quadriceps muscle
Phase 2 (Weeks 1-3):
Goals: Progress quadriceps/hamstring strengthening, independent mobility
Treatment plan:
1) Continue with swelling control
2) Progress strengthening
3) Balance and Proprioception: Single leg stance/weight shifting
Phase 3 (Weeks 3-5):
Goals: Full lower extremity strengthening/conditioning program, Full activity in gym
Treatment plan:
1) Progress CKC strengthening – lunges/ reverse lunges/ single leg squats
2) Full ROM – Full revolution on bike
3) Progress dynamic balance training
4) Sports specific strengthening and conditioning
Post-op exercise program until formal physical therapy is started:
Frequently asked questions
1) There is bleeding through the ace wrap on my knee, what do I do?
You may experience some bleeding or staining of the ace wrap/ dressing that has
been placed over the incisions of your knee. This is normal. Reinforce the
current dressing with sterile gauze and an additional ace wrap. All of this
equipment can be purchased at your local pharmacy. Remove all dressings 24
hours later and re-evaluate.
2) When can I drive?
You can drive when you have full control of the leg and you are not utilizing
narcotic pain medication.
3) Do I need to use crutches?
The crutches while recommended for at least 48 hours are not mandatory
assuming you did not have a meniscal repair. If you can ambulate with out pain
or instability you do not need to use crutches.
4) I have some numbness at the incision sites, is this normal?
Numbness at the region of the incision is a normal result of cutting the skin. The
numb region will likely decrease in size with time but may be permanent. No
loss in function is expected as a result of this small region of decreased sensation
5) What can I do to decrease the swelling in the knee?
Post operative swelling is normal after knee arthroscopy. You can decrease the
swelling by utilizing a compression wrap (ace wrap), ice and elevation
6) I have become constipated since the surgery, what should I do?
Post-operative constipation is often a side effect of the narcotic pain medication.
There are numerous over the counter remedies for this problem. Your pharmacist
is a great resource for this. Often Collace, a stool softener will do the trick. If
you go past 3 days without a bowel movement please call the office or you
primary care physician for guidance.