Well, it’s surgery time again. With families coming home from vacation, students getting ready to go back to school, medical deductables now paid, surguries are on the seasonal rise. This week I’ve had 2 separate calls on PT advice on ACL reconstruction so I thought I’d post some thoughts.

1. Do everything the surgeon and PT tell you, don’t cheat!
2. Using crutches and waiting a bit before the surgery will help get the swelling down. Getting pre-operative PT during this time is even better, you’ll know the exercises and the whole PT drill ahead of time.
3. If you do go for a cadaver graft (the advantage is that you don’t have another wound from the graft site), make sure you take it extra easy for the first few months, many with that surgery feel so good they stretch the graft out.
4. To decrease the pressure in the knee before and after surgery, wear shoes! Sandals MUST have an arch to them, no barefeet! Use Superfeet (full length blue if you can’t take the original insole out, green if you can, 3/4 length dress inserts in ‘Diesel’ like shoes) inserts in your shoes, they work (Dr. Scholls and most others are junk) and are inexpensive (compared to customs). Nordstroms, REI (and Ando & Aston Physical Wellness Therapy of course) carry them.
5. Make SURE you ask your doctor for, get and use a CPM, at night for sure, and through day, to get in your 8 hours. Arrangements for this have to be done BEFORE the surgery.
6. Make SURE you ask your doctor for, get and use an ice machine, even if you have to buy one for $2-300. It is worth it. Arrangements for this have to be done BEFORE the surgery. Ask for the size that holds 6 frozen water bottles instead of plain ice, the bottles will last 8 hours, ice 4-5, and getting up in the middle of the night to recharge the ice just won’t happen… cycle through another set of 6 bottles in the freezer, leave some an inch of airspace in the bottle when you fill, so they don’t split open when frozen.
7. Stay out of pools, tubs until the wound is completely closed. When showering keep the wound dry using a simple sealing technique I have used several times myself. Use a thumb-size piece of Vaseline, spread it in a 2-3″ wide path completely around, but not touching, the wound, cover this with a single piece of plastic kitchen wrap. Have a paper towel handy to wipe up the Vaseline after showering.
8. Only take the serious pain meds (Vicodin, Percocet, Darvocet, Tylenol w/codeine etc) only when you have pain, taking it by time is a sure way to increase risk for developing a dependency in just a few days. This does not apply to over the counter pain meds like Advil or regular Tylenol.
9. Remember: most ACL reconstructions come out stronger than the original ligament, so work hard in PT and hang in there!

Comments are welcome.
Dr. Art Ando
Physical Therapist