After ACL Reconstruction Surgery: How to Care for Your Child

Your child had ACL reconstruction to fix a torn ACL (anterior cruciate ligament) and is now ready to go home. Your child may need crutches and a leg brace after surgery. Most children are back to all regular activities and sports 6–12 months after surgery. 

Follow these instructions to care for your child as he or she recovers. 

Your surgeon will provide instructions for:

• what medicines to give your child for pain

• how often to apply a cold pack to the knee. Put it over the bandage or wrap it in a towel. Don't put the ice directly on the skin.

• when to take the bandages off. Do not get the bandages wet. If your child needs to shower, cover the knee in a cut plastic bag or plastic wrap and tape in place. 

• wearing a brace, if your child needs one

• using the crutches, and when your child should stop using them

• using the continuous passive motion (CPM) machine

• what exercises and stretches your child should do

• when your child should start physical therapy (PT). PT will help with balance and improve knee flexibility and strength.

Help your child find ways to stay busy during the recovery. For example, he or she can stay involved in sports by keeping score or by being a team manager. If your child wants to do something besides sports, help him or her try a new hobby like playing the guitar, painting, or drawing.

Your child:

• can't pee by evening on the day of surgery

• has a stiff, sore, or swollen calf

• has swelling or numbness that is not relieved by loosening the bandage and raising the leg up on a chair or pillow

• has a lot of bleeding from where the incisions were made

• has severe pain after 48 hours

• has a fever

Your child:

• develops chest pain or shortness of breath

• has significant calf pain

What happens during ACL reconstruction surgery? The surgeon uses a graft (piece of tissue) to reconstruct (rebuild) the ACL. The graft can be a tendon — with or without bones attached to it — from the patient's own body (an autograft), from someone else who donated the tendon (an allograft), or a combination of both. Your surgeon may use anchors and screws to secure the new ACL to the knee.

When can my child stop using the crutches? Your child may stop using crutches as soon as the pain is better and the knee is strong enough and feels stable. This can take only a few days or several weeks. Follow the surgeon's instructions about whether your child needs to use a brace after he or she stops using crutches.

When can my teen drive? Teens can start driving again after surgery if:

• They are not taking any prescription pain medicines.

• The surgeon says it's OK. 

How can we prevent another ACL tear? Neuromuscular training (NMT) programs may help your child avoid another ACL tear. These programs teach movement patterns that lower the risk of injury, especially while jumping, landing, and changing direction. NMT programs include stretching, plyometrics (jump training), and balance training. Ask your surgeon if an NMT program is right for your child. Doctors are researching whether any type of brace may lower the risk of ACL injury, but this is still unproven.