Anterior Cruciate Ligament Reconstruction

Post-Surgical Instructions

Knee Brace

Tighten the straps of the knee brace to prevent it from slipping when walking
To be worn continuously for the first 6 weeks after surgery, including sleeping time
To remove during shower, exercising, icing or, when checking skin condition and to relieve pressure on the skin from the brace a few times a day.
Do not wear the ice pack with the knee brace

Crutches

Crutches to assist in walking should be used for a minimum of 2 weeks. Your physiotherapist will advise you on progression of crutch usage.

Cryotherapy

An ice pack can be applied to your operated knee for 15 to 20 minutes after each exercise session to relieve pain and swelling, and at regular intervals of up to 3 to 5 times a day.

Swelling

It is normal for your operated knee to be slightly swollen after surgery. This can be controlled by regular cryotherapy, keeping your leg in an elevated position, use of a compression bandage and by avoiding excessive walking.

Rehabilitation plan

The therapy plan is generally divided into 2 phases:

First 3 months: Early post-operative management and strengthening
From 4th month onwards: Functional rehabilitation, with a gradual return to sports, between 6 to 9 months from date of surgery

Your therapist will guide you through an individualised rehabilitation programme based on your rehabilitation goals and expectations. You will need to commit time to attend physiotherapy sessions, as well as work on your home exercises. The successful outcome of your surgery is dependent on this. Do discuss any difficulties you may have with your physiotherapist or doctor.

Home exercises

Do the following exercises 3 times daily

1) Knee flexion exercise Sit with a smooth surface under your operated leg. Place your hands under your knee or hold a towel under your heel. Slide your heel up to the board. Hold 10 seconds then slowly lower. Repeat 10 to 20 times. Do not use excessive force, and do not bend beyond 90˚.
2) Hamstring stretch Sit with your operated leg straight in front of you, the other unaffected leg bent. Press down on your knee, and slowly lean forward. Hold 10 seconds, repeat 10 times
3) Quadriceps strengthening exercise Static Quads Lie with your unaffected leg bent. Tighten the quadriceps of your operated leg by pressing your knee downwards. Hold 5-10 seconds then relax, repeat 10-20 times.
Straight Leg Raise If possible, progress to ‘locking’ your knee and then lifting your whole leg off the surface. Hold 5-10 seconds, repeat 10-15 times

Warning

Do not endanger the surgical graft by aggressive rehabilitation. All exercises taught should be done in a slow and controlled manner. And should not result in any pain. If you are experiencing any problems, stop the exercise and inform your physiotherapist.
Do only exercises that were taught to you. Do not perform other exercises without first checking with your physiotherapist

Outpatient Physiotherapy Appointment

You should be given an outpatient physiotherapy appointment within 1 to 2 weeks from the date of surgery. If you have not received an appointment, do contact the Singapore General Hospital Ward or Ambulatory Surgery Centre