ACL Surgery: How to Prepare

The anterior cruciate ligament (ACL) is the main stabilizing force in the knee. When it is injured or torn, repair requires an extensive recovery period. While surgery is an option for management of an ACL injury, treatment begins long before your surgery date.

Location

ACL reconstruction usually occurs in an outpatient surgery center. General anesthesia is used, but your doctor will make the repairs through small incisions in the knee. You can typically go home the same day as your surgery.

If you have any problems from anesthesia, you may need to be monitored in the hospital overnight. You will also be asked to practice using crutches before your doctor clears you to go home.

Doctor checks patient's knee in preparation for ACL surgery
Pornpak Khunatorn / iStock / Getty Images

What to Wear

You do not need to wear anything special on the day of your surgery. You will be asked to remove your clothing and change into a gown when you arrive at the surgery center.

Bring loose-fitting, comfortable clothing to wear home from your surgery. Bending your leg may be difficult or painful at first.

Food and Drink

Your doctor will talk to you about eating and drinking before surgery. When you are undergoing general anesthesia, your doctor will give you specific instructions on how to prepare.

Eating or drinking before general anesthesia could increase your chances of vomiting or aspirating—a condition where fluid from your stomach or mouth enters your lungs. Your doctor should advise you to:

  • Not eat anything after midnight on the night before your surgery
  • Not to eat anything on the day of surgery before your arrival
  • If you have something to drink on the day of surgery, clear liquids are preferred

Medications

In addition to restrictions on eating or drinking, your doctor may ask you to stop taking or change some of the medications you usually take before the day of your surgery. Some medications can make your surgery dangerous. These include such as blood thinners and some vitamins.

Some medications may have to be tapered or stopped carefully. Discuss plans to stop or pause any of your medications before your surgery with your doctor.

Some of the medications doctors will usually ask you to stop in the weeks or days before surgery include:

  • All nonsteroidal anti-inflammatory drugs (NSAIDs): These include ibuprofen and aspirin and should be stopped about a week before surgery. They thin the blood and increase your risk of bleeding during surgery.
  • Prescription blood thinners: Prescription blood thinners should be stopped before surgery, but your doctor will advise you on how and when to stop these medications. Some medications in this group include Plavix (clopidogrel), Lovenox (enoxaparin), Coumadin (warfarin), and Eliquis (apixaban).
  • Vitamins and supplements: Make sure you tell your doctor about any supplements or vitamins you take. While these seem harmless, these can have negative effects on your body during surgery. Some supplements your doctor may advise you to avoid include vitamin E, ginseng, glucosamine, fish oil, and ginkgo biloba.

Talk to Your Doctor First

Make sure to discuss what medications you take routinely with your doctor. Some medications can cause complications during or after surgery.

What to Bring

Since your ACL repair will likely be done as an outpatient surgery and you will go home the same day, you should not bring too much with your to the surgery center. A few things to remember are:

  • Your medical insurance card
  • Identification
  • Cell phone if you need to reach family
  • Someone to drive you to and from your surgery
  • Comfortable, loose-fitting clothing to wear home
  • Slip-on shoes
  • Crutches, if you already have them
  • Knee brace or splint, if you already have one

Pre-Op Lifestyle Changes

In the weeks before your ACL repair, physical therapy is crucial. Surgery for an ACL repair doesn’t usually happen until up to six weeks after the initial injury. The biggest deciding factor in when to have surgery is the condition of the injured knee.

You will need to take care of the injury to reduce pain and swelling, and restore full range of motion. This usually requires intense physical therapy.

Your doctor will also advise you to quit smoking, and avoid using alcohol or other drugs before your surgery. Tobacco use in particular is associated with slower healing after surgery.

A Word From Verywell

Surgery is just one piece of ACL repair. Recovering from an ACL injury or tear requires lengthy rehabilitation both before and after your surgery date, should you choose to have surgery.

Surgery to repair at ACL isn’t necessary in all cases, and you should make sure to talk to your doctor about whether more conservative management options would work for you.

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Article Sources
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  1. American Academy of Orthopaedic Surgeons. Knee arthroscopy. Updated September 2016.

  2. UCLA Health. When to stop eating and drinking.

  3. Johns Hopkins Medicine. Preparing for surgery.

  4. Friedberg RP. Anterior cruciate ligament injury. UpToDate. Updated March 4, 2020.