Anterior Cruciate Ligament (ACL) surgery is a reconstructive procedure performed to restore stability and function to the injured knee joint. While the surgical technique itself is a significant factor in a successful outcome, the preparation leading up to the operation is equally important for a smooth recovery. Taking proactive steps to optimize the body’s condition minimizes surgical risks and significantly improves the post-operative rehabilitation process. Understanding what actions and substances to avoid prevents complications like excessive bleeding, surgical cancellation, or a more challenging healing trajectory. Following all pre-operative instructions diligently is the first step toward returning to full activity.
Physical Activities to Avoid
Once a torn ACL is diagnosed and surgery is scheduled, it is important to avoid any movement that could cause further mechanical damage to the knee joint. High-risk activities that require sudden changes in direction, known as cutting or pivoting motions, should be avoided. Continuing to participate in sports like basketball, soccer, or tennis increases the chance of creating secondary injuries, such as meniscal tears or cartilage damage, which complicate the surgery.
Any activity that involves jumping, hopping, or running must also be eliminated from the routine, as these movements place uncontrolled, high-impact stress on the unstable joint. Even in daily life, care must be taken to prevent the knee from “giving way” or buckling. Utilize crutches, a brace, or other assistive devices as directed by the medical team to maintain stability and protect the joint from accidental movements. Ignoring new or increased pain signals and attempting to push through instability can worsen the knee’s condition, potentially delaying the scheduled operation.
Medications and Supplements to Discontinue
A wide range of common over-the-counter medications and dietary supplements must be discontinued before ACL surgery due to their potential to interfere with the body’s clotting mechanisms. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve), function as blood thinners and should be stopped well in advance. These substances inhibit platelet aggregation, which is necessary for proper blood clotting, thereby increasing the risk of excessive bleeding during and after the procedure. Aspirin, even in low-dose regimens, also falls into this category and must be paused unless specifically instructed otherwise by the prescribing physician.
Certain herbal supplements are also known to affect coagulation or interact negatively with anesthesia. Supplements with documented anti-platelet effects should be stopped, often for up to two weeks before surgery. These include:
- Fish oil
- Garlic
- Ginger
- Ginkgo biloba
- High-dose Vitamin E
Other substances, including St. John’s Wort, can alter the metabolism of anesthetic agents, making them less effective or increasing the risk of adverse reactions. Patients who are taking prescription blood thinners must consult their surgeon and cardiologist to create a safe, supervised plan for temporarily stopping or bridging the medication.
Lifestyle Factors That Compromise Healing
Habits that impair the body’s ability to recover must be addressed immediately upon scheduling surgery. Smoking is a significant factor that negatively affects surgical outcomes, primarily by constricting blood vessels and reducing oxygen delivery to the tissues. This poor circulation compromises the ability of the surgical site to heal and increases the risk of infection and graft failure.
Alcohol consumption should be reduced or eliminated in the weeks leading up to the procedure. Excessive alcohol intake can contribute to dehydration and may interact unpredictably with anesthesia and post-operative pain medications. For individuals with chronic conditions like diabetes, maintaining stable blood glucose levels is important. Uncontrolled high blood sugar impairs the immune response and slows down tissue repair processes, which can lead to complications with wound healing after surgery.
Procedural Mistakes and Communication Failures
Adherence to the immediate pre-operative instructions is mandatory, as failure to comply can lead to the surgery being cancelled on the day of the procedure. The most commonly overlooked rule is the fasting protocol, which prohibits eating or drinking anything after a specific cutoff time, typically midnight the night before surgery. A full stomach poses a serious aspiration risk during general anesthesia, where stomach contents could enter the lungs, causing life-threatening complications.
Patients must be completely transparent with the surgical team regarding their medical history and current health status. Failing to disclose all medications, including over-the-counter drugs and supplements, or not mentioning recent illnesses, even a minor cold or fever, can compromise anesthesia safety and increase infection risk. Neglecting required pre-operative hygiene instructions, such as special antiseptic skin washes, increases the presence of bacteria on the skin. This omission elevates the risk of a surgical site infection, directly impacting the overall outcome and recovery timeline.