The anterior cruciate ligament (ACL) injury often requires reconstructive surgery to restore stability and function to the knee joint. This procedure marks a significant step toward regaining an active lifestyle, but its long-term success relies heavily on thorough preparation. Preparing for ACL surgery requires a focused effort encompassing physical strengthening, medical clearance, and detailed logistical planning. A proactive approach in the weeks leading up to the procedure can significantly improve post-operative outcomes, reduce recovery time, and ease the transition back home.
Physical Strengthening Before Surgery
The period between injury and surgery is an opportunity for prehabilitation, which aims to optimize the knee’s condition. The stronger the injured leg is before the operation, the faster and smoother the recovery process will be. A primary goal of prehab is to ensure the injured knee can fully straighten, as this ability is a strong predictor of post-operative range of motion.
Prehabilitation programs focus on strengthening the muscles surrounding the knee, particularly the quadriceps, hamstrings, and gluteal muscles. Quadriceps-focused exercises, such as the quadriceps set, are foundational for restoring muscle control. Low-impact movements like straight leg raises and gentle heel slides help maintain or improve range of motion.
Managing inflammation is essential, as excessive swelling can delay the surgical date and complicate early recovery. Patients should use ice and elevation frequently, for 15 to 20 minutes multiple times a day, to minimize fluid buildup. Working with a physical therapist provides personalized guidance on exercises and safe progression, ensuring the knee is in the best possible state for the upcoming reconstruction.
Necessary Medical and Administrative Clearance
Beyond physical readiness, a series of medical and administrative steps must be completed to ensure the surgery proceeds safely. The surgical team requires full medical clearance, which often involves pre-admission testing to evaluate overall health. These tests can include blood work and sometimes an Electrocardiogram (EKG) to check heart function, especially for patients over 50 or those with pre-existing conditions.
All current medications, vitamins, and supplements must be reviewed with the surgeon and anesthesiologist. Substances that increase bleeding risk, like aspirin products, anti-inflammatory medicines, and blood thinners, must be stopped seven to ten days before the procedure, following specific medical direction. The hospital also needs signed consent forms and confirmed insurance authorization, which should be verified well in advance. Patients should arrange for any necessary work restrictions or short-term disability paperwork to be processed before the surgery date.
Preparing Your Home and Support System
The first few weeks after ACL surgery involve significantly limited mobility, making a prepared home environment and a robust support system necessary for a safe recovery. Set up a primary recovery area on the ground floor to minimize navigating stairs with crutches. This area should be equipped with a firm couch or bed and plenty of pillows to keep the leg elevated above the heart to control swelling.
Fall prevention is key, as using crutches significantly increases the risk of tripping. All loose throw rugs, electrical cords, and clutter must be removed from high-traffic pathways to create clear routes. For the bathroom, installing a shower chair, grab bars, and a raised toilet seat can improve safety and independence.
Stocking up on easy-to-prepare meals, necessary supplies, and placing frequently used items—such as remote controls, phone chargers, and medications—within easy reach is important. Arranging for a caregiver to stay for at least the first 24 to 48 hours is essential. This person can provide assistance with mobility, meal preparation, and transportation.
Immediate Steps on the Day of Surgery
There are a few immediate instructions that must be followed. The most important instruction is the fasting requirement, which means no food or drink after midnight the night before the surgery. If the surgery is scheduled for later in the day, the medical team will provide a specific time, often eight hours before the procedure, after which nothing should be consumed.
Patients are usually allowed to take certain prescribed morning medications with only a small sip of water, but this must be confirmed with the surgical team. Wear loose-fitting clothing, such as shorts or sweatpants, that can easily accommodate a bulky post-operative dressing and knee brace. Essential items to bring include a photo ID, insurance card, and the knee brace if one was pre-fitted. A designated driver and caregiver is mandatory for discharge, as the effects of anesthesia and nerve blocks make driving impossible.