Rehabilitation of an ACL reconstructed knee begins the day of surgery. Most patients are fitted with a continuous passive motion (CPM) machine immediately after surgery. Additionally, patients are fitted with a full leg/knee brace & crutches, and are given exercises immediately post op in the hospital.
You should use this machine 2-3 hours at home twice daily for a total of 4-6 hours per day. The company will explain how to operate the CPM. Your goal with this machine is to achieve 90-100 degrees of flexion (bending) comfortably. Every time you use the CPM you should try to increase the flexion by 5 degrees. You will experience some discomfort while trying to increase your flexion. Once 95 degrees is obtained you may call the company to pick up the machine. Also, remember to take off your brace while using it.
Many doctors order different knee braces. The knee brace given to you immediately after surgery must be worn while walking and sleeping. Depending on the doctor's instruction you may take the brace off when doing exercises and/or for using the CPM machine. Brace hinges must be at the level of the knee cap. You may loosen or tighten the brace straps as necessary. It is important to keep the top straps tight in order to prevent the brace from moving up and down on the leg. Most doctors prescribe wearing the brace for about 4-6 weeks. While putting your brace on, it is easier to keep your leg straight and your thigh muscle tight.
You may shower 48 hours after surgery, however you must cover the stitches that you now have. Usually a plastic bag or wrap will do. If you can put a chair or stool in your shower you will find it much more comfortable and easier to clean yourself. A hand held shower washer will allow you to get to the hard to reach places. Whatever you decide to do please use CAUTION!! Be careful not to slip, twist, or fall. Do not soak in a bath tub, hot tub, or pool until the doctor tells you it is O.K. to do so. Once you are done showering pat the wound dry.
Unless otherwise advised, remove all cotton and yellow gauze 48 hours after your surgery. Leave steri-strips (white paper strips) on your wound until you see the doctor. Reapply ACE bandage. You do not need to place a new dressing on your knee.
When you are not walking, your leg should be straight with a pillow under your foot or ankle (not behind your knee). Try to elevate knee as much as possible to reduce swelling. This means that the level of the knee must be above the heart.
Physical therapy & CPM will help your regain knee flexion (bending). However, being able to fully extend (straighten) your knee soon after surgery is vital! If full extension is not achieved within the first eight weeks, a second surgery may be necessary. With this in mind, you must never Never NEVER put anything under your knee when you are resting, sleeping, or propping your leg up. The pillow must go under the heel.
You should ice the knee as often as possible (especially after exercising) to reduce swelling and discomfort. Do not ice the knee more than 20 minutes at a time. Let the knee warm up before reapplication. Avoid getting your wound wet. 10-15 minutes several times per day is adequate.
Use the crutches when walking as the physical therapist taught you in the hospital. Different doctors have different recommendations so follow the protocol that they have for you.
You need to see the doctor about one to two weeks following surgery for your first post-op visit. At that time your sutures (stitches) will be removed. If you haven't started already you will be given a prescription to begin physical therapy.