On the day of the surgery you will meet with your child’s surgeon, anesthesiologist and nursing team. They will ensure your child is well enough to participate in the surgery and confirm you have followed the how to prepare for surgery instructions below.
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During the surgery, your child will be given a general anesthetic to put them to sleep. Timing for this surgery varies.
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Do not take any anti-inflammatories (ibuprofen, naproxen, aspirin) for at least five days before surgery.
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Purchase or rent a pair of crutches and bring them with you on the day of the surgery. To learn about crutch walking, you can visit CHEO’s website for a video tutorial. If your child has been prescribed a brace, bring this with you on the day of the surgery as well.
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Give acetaminophen (like Tylenol® or Tempra®) and over-the-counter cold medications or antibiotics as needed or prescribed.
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Tell your doctor if your child bruises easily, or if anyone in your family has had problems with anesthetic or bleeding tendencies.
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Make travel plans as necessary. If you live outside of Ottawa, you’ll have to plan ahead. For families from out of town or wanting to stay close to a child in critical care, there are two reasonably prices overnight accommodations across the street from CHEO.
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Ronald McDonald House provides a home away from home feel, where rooms are reserved for families of children undergoing complex treatment or procedures. These rooms require a referral from a social worker, nurse or other member of your health-care team.
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Rotel rooms provide a place to stay for any family members and friends visiting patients at CHEO. For reservation information, call 613-733-1412.
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Children and youth are ready to go home about 2-4 hours after the surgery is complete.
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Contact a physical therapist to arrange for physical therapy to start within 1-2 weeks after surgery.
Pre-habilitation (pre-hab) therapy.
Start a pre-operative rehabilitation (pre-hab) program with a physiotherapist as soon as possible before surgery. A stiff and swollen knee that does not have good range of motion at the time of ACL reconstructive surgery may have problems with post-operative rehabilitation. Research suggests that pre-hab provides better post-operative outcomes and improves range of motion.
Caring for your child or youth after surgery
Incision care
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Follow the surgeon’s instructions on how to care for your child or youth’s incision.
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Keep their bandage clean and dry if there is one covering the incision. The stitches are typically dissolvable and they do not need to be removed. Your post-operative instructions will inform you when to remove the dressing.
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Leave the Steri-Strips® (white tape) on until they fall off on their own in 2-3 weeks.
Bathing
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Your child or youth can take a shower after the wound has healed for five days. When you have your follow-up appointment, the surgeon will let you know when it is OK to submerge the leg in water. Avoid using soap, lotion or powders directly on the incision.
Medication
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Give Acetaminophen every 4-6 hours. Do not give more than five doses in a 24-hour period.
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Give other medications only as prescribed by your surgeon. Morphine or other pain medication may be prescribed.
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You may give Gravol for nausea and stool softeners for constipation if required.
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You can discuss with the anesthesiologists whether you would also like a regional nerve block, which can help with some of the initial pain in the early post-operative period. To learn more about Anesthesiology and pain medicine - CHEO.
Activity
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Your child can put as much weight on their leg as they feel comfortable. If they had a meniscal tear repair (piece of cartilage in your knee that cushions and stabilizes the joint), their surgeon will ask them not to walk on their leg for six weeks. During your follow up appointment your child’s surgeon will tell you when they can put more weight on the foot.
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Sometimes your surgeon will prescribe a brace to keep your knee straight. You will probably use this brace for 2-6 weeks after surgery. You can take it off while not standing on your leg (for example while resting, sleeping, or during physiotherapy and rehabilitation).
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Youth cannot drive until they have complete control of their leg and are off crutches. Usually this is not for at least 4-6 weeks after surgery.
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Physical therapy should start within the first 1-2 weeks after surgery. It is important to remember to do the related exercises every day.
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Your child or youth cannot return to most sports until at least 6-9 months after surgery. They can begin jogging, cycling, and swimming before then. Your child's surgeon will see them prior to clearing them for sports activity.
Post-operative devices
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Cryotherapy device: helps to reduce swelling and pain by circulating cold water around the knee. A frozen bag of peas or cold packs work just as well but might be less convenient.
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Locking hinged post-op knee brace: might be prescribed by your surgeon to help with stability. These devices can be found from Ottawa retailers such as Kinemedics, Orthomedix, and Happy Brace Co.
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All patients will use crutches for 2-6 weeks following surgery.