ACL Reconstruction Postoperative Instructions

ACL Reconstruction Postoperative Instructions



1.         Do not progress faster than this protocol or the reconstruction may fail.

2.         Unless otherwise stated, perform 20 repetitions of each exercise 3-5 times daily.

3.         Perform exercises slowly, and hold each repetition for a count of 10.

4.         Follow-up appointments are typically weekly for the first month and then monthly for 6 months after surgery.

5.         Call for any questions or concerns.

6.         These instructions are a general guideline and patients may be told to alter the activity or exercise routine based upon individual circumstances.


Week 1

Incision:            Keep the dressing on for 2 days.  After that, change the dressing daily using gauze sponges and an Ace Bandage. You may take showers by wrapping the knee in saran wrap to keep the dressing dry.  If the dressing gets soaked, change it.

 Brace:              Keep the brace locked in full extension. Wear the brace at all times except during exercises and bathing. For exercises you may either remove the brace or unlock the hinges.  If you have not been shown how to unlock the hinges, remove the brace for motion exercises and you will be instructed how to lock and unlock the brace at your next follow-up visit.

Crutches:            Walk with crutches at all times (have to wear the brace). You may put all your weight on the operated leg.


1.         Heel Rolls: Put a pillow or towel under the heel and try to push the knee down towards the bed by contracting the quads. This helps to obtain knee extension, a prime goal after ACL surgery.

2.         Flexion:

-          Passive (Sit on a high surface and let the operated leg dangle so as to bend the knee.  You can also use the non-operated leg to pull the operated leg’s foot towards the body.)

-          Active (Lie down on your back and bend the knee while keeping the heel on the bed.)

3.         Quad Sets: With the leg straight, tense the quadriceps muscle.  This can be done even in the brace and helps to return tone to the quadriceps muscle in the postoperative period.

4.         Ankle Pumps: Alternately flex and extend the ankle (move the ankle so as to bring the foot up towards you and away from you) using the muscles in the leg.  This can be done even in the brace and helps to increase blood circulation in the operated lower extremity.


Other:  Cool the operated knee for 15 - 20 minutes at a time when the knee feels especially sore (e.g., after an exercises session or walking for a while).

Never put a pillow under the operated knee as this will tend to keep the knee in a bent position and we want a straight knee.

Sports:              None