Everything You Never Wanted to Know about Having ACL Reconstruction Surgery

When I found out I had to have ACL reconstruction surgery, of course I googled it, looking for people who had the same surgery. I found a few blogs about it, but I quickly found that reading them raised my anxiety level. Still, it was good to have a little information in advance from people who had been where I was going, so I'm going to pay it forward by writing about what happened to me. This promises to be a long, boring post, but hopefully it will help someone like me who wants to know exactly what happens when you have ACL surgery.

The surgical center I went to was Kerlan-Jobe in Los Angeles and my doctor is Dr. Daniel Kharrazi. So far, I've been really pleased with the treatment I've received from Kerlan-Jobe, Dr. Kharrazi, and especially the staff at Kerlan-Jobe.

Here's a run-down of what happened in the days preceding my surgery:

1) Pre-op Appointment

There was no examination given during this appointment. Instead, Kerlan-Jobe staff and Dr. Kharrazi's assistant asked questions about my medical history and gave me the information I needed to prepare for surgery. It also gave me the opportunity to ask questions, such as:

Q- How will I get up to my apartment after surgery
A- Crutches (It turned out I was a little too off balance to use the crutches and nearly feel over a couple of times on my way up in the elevator and the pathway into the condo. I ended up using one crutch and Mick to slowly hop from the elevator to our unit.)

Q- How soon can I shower?
A- Second day, but must keep brace and dressings dry. Best option is to put leg into a garbage bag and cinch it at the top.

Q- How soon will I be back in the gym?
A- Ten days to two weeks, after my first post-op appointment.

Q- How long will it take to reach my current level of function?
A- About six weeks

I recommend you write down your questions so you don't forget anything.

2) The paper work they gave me at the pre-op appointment indicated I would receive phone calls from the insurance department of Kerlan-Jobe and the anesthesiologist. The insurance call happened a few days before the surgery and verified that my insurance was covering the procedure after my $3500 deductible was paid. The anesthesiologist called the night before. It was a helpful call--he explained what anesthesia they'd use and how it worked.

Day Before Surgery

1) I prepared everything I could think of for when I returned home from the surgery. I set up a bed on the couch and replaced our big coffee table with a small end table so it could be easily moved. I set out the clothes I'd be wearing while I was "laid up," including socks and underwear, so my husband or myself could easily get it. I put items like rubber bands, glasses, and lip balm in a small bowl so I'd have them when I needed/wanted them. I set up an easily accessible power strip where I could plug in all my stuff--computer, iPad, iPhone.

Making the couch-bed up in advance was the best thing I did though. Try to anticipate your needs as much as you can and prepare in advance. It was great to be able to just go straight to the couch with everything within easy reach.

Day of surgery

1) We were told to arrive at 8am for a 9:30 procedure. When I got there, I had to sign a lot of forms. It was also the beginning of the question: "Which leg is it?" (the left one). I was asked that again and again, confirming and reconfirming it was my left leg being operated on.

2) A nurse called for me and took me to the pre-op room. There were about five beds there, each with a person waiting for surgery. One of them was an Olympic volleyball player, but for privacy's sake I won't reveal which one.

3) I was given a hospital gown and a warmed blanket and told to take everything off, put the gown on, and leave it untied in the back.

5) The nurse gave me a purple permanent marker and asked me to write "YES" with an arrow on the ankle of my left leg.

6) The nurse put cotton around my arm, then a blood pressure cuff which remained on throughout the procedure. She explained the cotton prevented irritation from the cuff since it had to be on so long. She also put a finger monitor on me and attached some electrodes (not sure if this is the right word, but you know, the sticky things they put on you so they can attach monitor wires.

7) She inserted the IV needle. I must say she wasn't the gentlest of nurses and this fell under the category of "no fun." After the IV was in she drew blood and then it pumped fluids into me, which caused my right arm to feel cold, but not uncomfortably so. They'll give you more heated blankets if you want them.

8) Next came the worst part: Waiting. And waiting and waiting. Not sure how long, but it felt like forever because at this point, the anticipation of what was to come was causing me a lot of anxiety.

7) Finally, one of the nurses who would assist during the procedure came in and introduced herself. She asked me again which legs was being operated on and I passed the test by saying "the left one."

8) The anesthesiologist came in and administered a sedative to keep me calmed while he injected the nerve block in my femoral nerve.

The "happy" medicine really worked. As soon as it kicked in I became very charming and entertained everyone within earshot with my pithy comments and fantastic sense of humor.

The nerve block is injected into your femoral nerve and completely numbs the area. It's effects last from 10-16 hours and it helps with the intense pain immediately after the surgery.

When he injected it, the muscles in my thigh started twitching violently. Thanks to the "happy" drip I laughed through the whole thing.

9) They wheeled me into the operating room, where "Welcome to the Jungle" was playing which elicited comments from the nurse and anesthesiologist. I told everyone I wasn't familiar with the song because it was "before my time." (see reference to pithy/funny comments above).

10) They helped me get onto the surgical table, where I lay staring up at the ceiling. That's my last memory.

Post-op

1) I woke up in the post-op room with a nurse standing beside me, helping me "come back." She offered me crackers and soda or water. My mouth was so dry I couldn't eat the crackers without taking sips of the soda in between.

2) They administered more pain medication through the IV and gave me a Darvocet and an anti-nausea pill since I told them I'd had bad experiences with Percocet and Percodan.

3) They brought Mick into the post-op room. Boy, was I happy to see him!

4) The surgeon's assistant, who is a very handsome man, came over and explained what I needed to do between now and my first post-op appointment.

-Keep leg straight at all times
-Keep brace on at most times (he said I could open it up and let it "breath" now and then, but I haven't done that yet).
-Increase food intake gradually
-Remove dressing in 2 days and apply new dressing
-Put no weight on leg until nerve block effects dissipate as the muscles are too weak to hold any weight
-After nerve block wears off, partial weight on leg, with crutches

I should point out here that different surgeons have different protocols. For example, your surgeon might have you start using the continuing motion machine (more on that in another post) as soon as you get home. Mine doesn't want me to start that until after my post-op appointment. Follow your surgeon's instructions!

5) The nurse helped me put my pants on, then removed my IV and electrodes and transferred me to a wheelchair. She let me put on my shirt by myself though. After that she wheeled me to the restroom.

6) An orderly wheeled me downstairs, where Mick was waiting with the car. Do yourself a favor and make sure your back seat is clear, because that's where you'll probably have to sit. Mick and I's back seat was covered with ski equipment and he had to scramble to remove it all so I could get in.

Home at last!

1) I spent the rest of the day entirely on the couch. There was a lot of drowsiness so I just turned on a DVD and let myself go in and out. I found I was pretty content to just lay there without any entertainment at all in fact. I guess the one good thing about surgery is that my normally active and neurotic mind has been shut off.

2) It took a few rounds on the crutches before I felt secure using them. I didn't try to get up unless Mick was there to supervise.  But now, the next day, I'm much more confident and independent (though still won't use the crutches if Mick isn't in the house).

3) There is some pain, but it is manageable. Mostly it feels like I'm straining the muscle in the back of the knee. When I move there is additional pain on the top right of my knee and it feels like I shouldn't do it, but if I push past that initial moment of pain I find it's not unbearable and I can go about doing what I need to do.

4) I slept well last night. The only problem is staying one position all night--I woke up pretty sore.

5) The pain pill situation is interesting. Up until about an hour ago I hadn't experienced any nausea, but right now I'm feeling it. I'm also sweaty and a little clammy.  I think I'll reduce my pain medication the next time I'm due to take it.

6) Today Kerlan-Jobe delivered the continuous motion machine and a Game Ready ice machine. Like I said, I won't be using the motion machine for awhile but I started with the ice today and kept it on (intermittently) for about 4 hours. It definitely reduces the pain, and consequently, I've been able to reduce my meds. Believe me, I'm not trying to be a hero, nor do I oppose being drugged at this time in my life, but the risk of nausea makes me reluctant to take them.

Okay, that pretty much does it for what happens during surgery. It is definitely not the most pleasant thing in the world but it's not as bad as I thought it would be. Actually, it's about as bad as I thought it would be, but I'm in a much better place than I expected, probably because I'm sleeping so much. I'm sure the time will come when I go stir crazy and get depressed but so far it hasn't happened. I'll post more about it if/when something that I think will be helpful to other people happens.

Before I go, quick shout out to my wonderful husband Mick who has been at my beck and call since yesterday (some would argue since he married me). Seriously, I could not get through this without him.

Finally, if you made it to the bottom of this post, here's a reward.

Comments

[J Clarke]

Thanks for the post, I actually enjoyed it, after recently going through reconstructive hand surgery. They also did a 20 hour block on the 2 nerves in my hand, but let me tell you, it wasn't pretty when I woke up. I had a cast on that was too tight and I thank God I was staying with my mom, the nurse, who called the doctor. My surgery was President's Day Weekend Friday so I had to make do with a halfway cut open cast (Dr's orders) through Monday to Tuesday (my birthday - nice). Then I went to the dr for a new cast and much more pain medicine, as I've said. I like how funny you got on the loopy drugs. I was just hilarious as well. I also agree that it helps to have an excellent caretaker/team. When i had my knee surgery, for two days, my dad had to carry me around. When I was at Kerlan Jobe it was Senior Yr at LMU at I had Dr Gambardella (Joe Montana) do my elbow reconstruction and their PT Dept was fabulous. My famous person down the hall was Magic Johnson, who had a concussion form the game the night before (they actually kept me two days). Heather and I tried to walk down the hall but I threw up so we went back. Best to you, Holly.

[Holly]

Julie, it's been so good getting back in touch with you. What happened to you hand so you needed the surgery?

[Sharon O.]

The reward was sooo worth it! I did enjoy your blog, too. I think it would be helpful to someone else who may be getting ready for the same procedure. You sprinkled that HOLLY DUST all around. Love you -- mom

[Steve Weddle]

Damn. Get well soon, etc

[Holly]

Thanks Steve!

[Rebekah]

I am pretty darn scared. I have to go in for surgery on Thursday. I am afraid that I won't be able to manage the pain. I get soooo sick from Narcotics.
I am just scared to death.

[Jamie]

Hello! I keep coming back to your post. I recently had ACL reconstruction, Friday August 27th. I was outpatient so i was home the same day. So it's only been 3 days. So far i'm doing okay, there's still some pain but manageable. Im wondering how you're doing now coz it looks like u had the procedure done 2 months ago. I'd love to hear it. Thanks for this post again. I am thinking of writing about my experience also.

[Holly]

Hi Jamie,

My surgery was on June 7, so its actually been almost three months now. I am doing well, and in most ways feel back to normal. I cant really run and do have chronic soreness, but thats to be expected and its very mild.

Im almost finished with physical therapy, which has done wonders for my recovery. Theyve made sure I dont limp when I walk and now theyre busy helping me strengthen all the muscles around the knee. Its amazing how quickly you lose strength.

If youre on day 3 you might find that the next couple of days are a little miserable. For me it took 10 days to really start to feel any bit of normalcy. I tried to get back on my feet by day 5, which for me was a mistake. I was in a lot of pain and really just miserable. I spent the next five days after that sleeping a lot and reading--I didnt try to do anything, I just wanted to get that time over with. My first post-op appointment was on day 10 and after that I started getting back to being myself again. So dont worry if you feel badly in the next few days. Days 4-6 were the worst for me.

Holly

[hannah]

thanks for the info!
i'm 18 and i have to have acl reconstruction in december. i have no idea what to expect out of this surgery; i had a meniscal scope in july because i also tore my meniscus, but i was walking within hours of that. your blog helped me a lot in understanding and knowing what to expect from this surgery!

[DR Tom]

The patellar tendon has (historically) been among the first preference for ACL reconstruction because of its close resemblance in size and strength to the ACL, and overall stability and integrity of the new graft.
www.health-tourism.com/anterior-cruciate-ligament-reconstruction/thailand/

[Ben]

Thanks for the Info.. Im having ACL LCL PCL reconstruction on the 18th of this month and was really nervous on what all would happen..

[Brian]

Thanks for the information. I am having surgery next week and I am somewhat nervous. Your blog has helped to calm my nerves! Many thanks and good luck with your full recovery.

[Marymarler]

Thank you for writing about your experience. I will be undergoing this surgery in 6 days and found oyur article very informative

[Ben Hannan]

Hi there,
Nice blog Holly. Good on your for sharing your experience.

I've done the same thing and have compiled a full structured list of things that need to be considered as people prepare for an ACL Reconstruction as well as a fully documented physiotherapy recovery program which helped me return to competitive soccer. It's part of a Complete ACL Reconstruction Guide. Details at: http://www.mykneereconstruction.com

All the best.
Ben Hannan

[Monica]

Thank you so much for this post. I tore my ACL on July 2nd and will be having surgery on the 26th. I really appreciate your suggestions for getting everything set up before you get home. Also your blog was the only one that didn't stress me out, thank you for being so upfront!!!

[Joe M]

Holly,
I had the surgery today. I am up (it's 3AM) looking for information on how long the femoral nerve block will last. I am a little freaked that my quad simply doesn't work. This is an informative post as I relived the days events through you words. Thank you. I will be back to read this again. You wrote, " I guess the one good thing about surgery is that my normally active and neurotic mind has been shut off." I guess it got turned back on just before you began writing. :-) I know how it is hence my comments at 3AM.
Regards,
Joe M

[Prashant]

This is a very good post... I had ACL reconstruction Surgery Last Week but still liked to read this

[Julian]

Great post! I just had Surgery to repair my diffused ACL. I spent last night at the hospital in recovery but am home today. I was wondering if yourself or anybody else who has had this surgery had problems with their leg twitching or spasming after the surgery?

[Hannah]

This is such an interesting post! I had my ACL Reconstrustion Surgery yesterday.. I havea huge fear of needles so I spent a lot of my time crying before and after surgery but my mom told me it was better to let all of my anxiety out because if I didn't I could have an anxiety attack and make things worse. It worked, I am only fourteen and after all nurses and my anesthesiologist knew they all tried to make me feel better. I love all the people who helped me out. Anyways, I had the Nerve block and was told it would last 24 hours. It wore off about 7 hours ago and i want it again. I am in so much pain. If you or anyone has tips to make me feel better it would be greatly appreciated! I am taking the pain pills they subscribed (1 pill every 3-4 hours) I have been taking it exactly at 3 hours. My Pain gets so bad when I move that I just bawl my eyes out. It is too intense.. Should I wait a day or two to talk to my doctor or should we let him know ASAP

[Emily]

So can you where underwear while you are in your surgery?

[Alexis]

Yeah, I have to get this done this Friday. I am SO SCARED! Reading this did help me out a lot though. I just have a quick question... I am SO SCARED of needles. Does the nerve block or whatever hurt?

[Chrissy]

I wish i would have found this before I had my surgery lol. I am now on day 3 and I am just uncomfortable. Thanks for sharing your experience so I can see what I have to look forward to down the road. Hope you and everyone else on this blog has done well with their recovery!

[Katie]

Thank you so much! I having ACL reconstructive surgery in the morning and was feeling the anxiety kick in... Reading this has put my mind at ease. Thanks again for posting such a thorough post. How was your recovery and how long until you were able to walk normal (without crutches) and upstairs?

[Holly]

It took about 10 days to walk without crutches and I don't remember how long it took to use stairs--maybe six weeks? That might be too long. By the end of 3 months I was going up and down stairs like nothing happened, but I was definitely able to climb them (albeit rather gimpy) way before that. Good luck w/ your surgery!

[Abegail Casidsid]

I would like to thanks the author for posting an informative article like this. It really help those people who are hopeless in their life especially those people who are experiencing a same circumstances.

Here are 7 benefits of the ACL Reconstruction:

1. Surgery is often done under a local anaesthetic resulting in shorter wait times, less trauma and faster recovery.
2. Success rate ranges from 82% to 95%
3.The patient may regain full range of movement and be able to return to previous levels of activity.
4. Prevent further tissue damage to the ACL.
5. Help to prevent early onset arthritis.
6. Provide relief from intense pain and swelling.
7. With the outpatient procedure there is less scarring and faster recovery

To know more about Pros and Cons of ACL Reconstruction, you can visit http://aclreconstructionsurgery.org/

[Bonnie]

Hi holly, I'm Bonnie and had my acl reconstruction in aug 2011. I tore it playing in my soccer game when I was tackled from the side. I'm doing well and wish I found this before I had surgery! I've learned so much about the knee throughout this experience and I've actually figured out that someday I want to be able to work in a hospital.