15 Surprises From My ACL Repair Surgery – What They Don’t Tell You

This post is part of a series. You may want to start here.

If your want the quick links, here’s the full series:

My Real Life Guide To ACL Surgery and Recovery

Injuring my ACL – My Story

ACL Repair – Timeline of My Recovery (With Pictures)

ACL Recovery – 15 Things I Would Have Done Differently

Gadgets That Helped My ACL Recovery

I recently had ACL surgery. Like most people about to go under the knife, I did a bit of research before my operation and I found all the usual stuff – anatomical diagrams of the inside of a knee, a description of what the actual surgery involves (lights, camera, scalpel).

It was a bit of a learning curve since I hadn’t even heard of an anterior cruciate ligament until mine went pop. And I found lots of medical stuff. Great.

What I didn’t find was a description of what it’s really like to have ACL repair surgery – and it turns out there were more than a few things that I didn’t know about the operation. So, in this article I’m going to share with you what the surgery was like for me together with how I’ve been recovering in the days, weeks and month post-op.

A couple of notes:

  • I had my surgery in the UK on the (public, not private) National Health System. I can’t imagine that the experience would differ that widely around the world but who knows…
  • As well as rupturing my ACL, I had a grade II tear to my MCL (not repaired) and a tear in my meniscus (repaired at the same time as my ACL).
  • Advance apologies if you’re squeamish – I’ve included a couple of pictures of my incision so you can see what it looks like. I’ll give you another warning just before you reach them!
  • When I say I recently had ACL surgery, I had it in 2016. What started out as once blog post about my experience has grown into a series of blog posts (see above for links).
acl repair surgery pre-op
You know – pre-planning for that awkward moment when the surgeon asks ‘my left or your left’ except you’re unconscious so he has to guess.

1. They shove a tube down your throat while you’re unconscious

acl repair surgery oxygen
Your throat is probably just sore from the oxygen they said…

I’m a grown up. I understand that there are things that need to happen while you’re being operated on. I just wish I’d been told in person (rather than finding out from Google) that they shoved a tube down my throat while I was out for the count. That way, I wouldn’t have been worried about why my throat was so damn dry and sore when I woke up. I also could have pre-planned and got some honey and lemon and throat sweets in for my post-op recovery.

2. They also insert a catheter and suppository

TMI warning

In fairness, they asked me if I wanted a suppository and my initial reaction was ‘urggghhhh. NO!’ until they told me it delivered 16 hours of pain relief. The idea of them inserting it while I was unconscious made me feel a little bit violated but I opted for that over having it inserted while I was awake, which would make me feel violated but with the added ‘bonus’ of a visceral memory of the event.

What they didn’t tell me (and I once again learned from Google) was that they also catheterised me. How did I surmise this? Well, I felt somewhat irritated in that area – something that lasted for around a week and made me wonder what they hell they’d done to me. Seriously, if you’re going to mess around in my ‘downstairs closet’ while I’m asleep, i) tell me about it; and ii) be gentle!

3. You’ll be weak…from hunger

I’m that person who needs to eat 10 small meals a day. Ok, that’s an exaggeration, but being nil by mouth from 8pm the night before until 3pm the following day can make you weak. Sure, I was fed tea and toast (which was a struggle to get down because of my dry mouth and throat), it’s simply not enough to sustain me.

The result – I felt very weak and sick when I tried to move from horizontal to upright on my crutches. The nurses were convinced I was having a reaction to the surgery. I was convinced it was something more simple – I was weak from hunger. A sandwich later and I was up no problem.

4. The end to end admission may take longer than you think

acl repair surgery operation
This irritating kit is unfortunately the last thing they remove before you’re allowed to go home.

I was first to surgery (around 10 a.m.) and with an op time of about 1.5 to 2 hours, I had ideas that I’d be home by mid-day. As it turns out, I got home around 8pm. That was partly because I had to sit with my leg in a knee bending machine for a few hours post-op but also because I was too weak to walk (see above).

5. The pain medication will probably make you feel sick

I was given co-codamol (codeine and paracetemol) as my main pain relief medication and boy did it make me feel sick. Ever drank too much coffee and felt jittery/like you want to vomit? That’s what the codeine did to me. It also made me want to nap within 15 minutes of taking it. As a consequence, by day two, I was already phasing it out and replacing it with just paracetemol and ibuprofen instead. The downside – I was in more pain that I probably needed to be in those first few days but at least I was alert and not feeling sick.

6. It hurts (more than you think)

acl repair surgery recovery
My friend bought me these Minion socks – helped with the pain. Btw, that’s a DVT sock on my right leg. You’re advised to wear them post surgery and I was given a couple of packs in the hospital.

Of course I knew the operation wasn’t going to be a walk in the park (nor afterwards!) but the intensity of the pain in those first 3-4 days surprised me. Not feeling able to take the co-codamol didn’t help. The good news is that although the pain is bad those first few days, it does ease and I was on off-the shelf painkillers within a few days.

7. The pain medication will probably give you constipation

Another TMI warning

We all know what constipation is. Fortunately, my physio had pre-warned me and I just chilled out about it, waiting for my body to right itself. Which it did and within the week things were back to normal.

8. The surgical dressings will hurt as much as the incision

acl repair surgery dressing
Getting creative with my clothing to give the incision some air while trying to keep warm! ACL repair surgery is not a cold weather activity.

It didn’t occur to me that this would happen. I possibly didn’t help myself – I’m the kind of person who needs some sort of shower every day to feel like I’m not a slob. This meant I was changing my dressing daily – I had staples rather than stitches and was told not to get them wet (nurse: ‘you don’t want sticky staples’). I also kept my dressing on as long as the staples were in because my body magically started to push the staples out around week one and I didn’t want to snag anything.

Upshot: this constant pulling off and putting on of adhesive dressing took its toll. In fact, I’ve had the dressing off for nearly a week and the skin where the dressing stuck is still tender. I have been using Elizabeth Arden’s 8-hour cream. It’s not your average moisturiser – it has a bit of a medical scent to it and it has amazing repairing properties which have really soothed my skin.

9. The small incision – not as small as they say

Just a couple of camera holes and a small incision. Yeah right. My incision is a couple of inches long – which looks a lot on a 5ft tall person. Pre-surgery, I’d just seen the scars from other people, which were a lot smaller because, well, healing and all that. I know my incision scar will shrink too but that first time I saw the cut, I was a bit shocked. Photos of the incision further below.

10. Bathing is an epic challenge

At the time when you need stability in the shower the most, ACL repair surgery takes one leg out of action. Had it been decent, I’d have videoed the various poses I found myself in while I simultaneously tried to wash my body and hair while keeping my dressing dry. I have to say, my yoga came in very helpful.

By about day 10 I simply gave up and just showered faster.

After three and a bit weeks, I’ve finally had a soak in a bubble bath – I was advised to wait a little in case the fragranced products irritated my skin after having the staples out. To be on the safe side, I went with a baby bath foam which I knew was going to be gentle on my incision.

The rest of the time, I’ve just been using my L’Occitaine Lemon Verbena shower gel as usual and this week I’m going to buy some Bio-Oil to help reduce scarring. Some articles say don’t bother but I say nothing ventured, nothing gained.

11. Having your staples out is brutal

acl repair surgery staple extractor
My very own staple remover!

I’ve had stitches removed before and apart from feeling a bit queasy (I was 10 years old – I was allowed to feel queasy), it didn’t hurt. For some reason, I thought having my staples removed would be the same. Not so.

It hurt like hell!

First of all, they use a sharp, metal staple extractor – in fact, I was supplied this in the hospital and for a good few seconds I thought I was looking at a DIY jobbie until the nurse read the horror on my face and reassured me it was just to take to the clinic; I didn’t have to pull them out myself at home.

The problem with this tool is that to get the staples out, it needs to fit under the staples – which is right where your skin is most tender at the point of incision. Some of my staples had lifted themselves up a good few millimetres by the time of removal which I was so grateful for. I can’t imagine the pain if they were still flush with my incision. Take pain pills before you go and take comfort in the fact that there are people who have more staples inserted that you would after ACL repair surgery. Plus, the relief of having them out is worth the pain.

12. Initial progress will be quicker than you think

acl repair surgery knee bending
I was horrified I was going to be tortured when I saw this contraption but I give it full credit for getting my knee bending quickly post-op

I couldn’t believe the hospital had my leg bending back to 45 degrees within just a few hours of surgery. Sure, the contraption was fresh out of a horror movie, but it did an excellent job. I was also given stair and crutch training, which gave me the confidence to go home that day. I was told I could weight bear and within a few days I was taking steps without crutches – I’d expected a much slower start to my recovery and I was frankly delighted with myself.

And here’s the contraption in action just a few hours post-surgery…

13. ‘Back to normal’ progress will be slower

And those early days gave me false ideas about how quickly I’d progress. Sure, I’m swifter moving around without crutches but weeks 1 to 3 have seen pretty much that same level of progression. I’m still taking stairs by putting both feet on each step and although my knee bend has moved on to over 110 degrees, that’s a bit of a no-man’s land in terms of usefulness – most activities (kneeling, bending crouching, going down stairs) require closer to 180 degrees. Impatience has taken hold. Fast.

(On the plus side, all this feet-up, stay indoors business means I’m finally catching up on some of the books on my reading list).

I should say that I also had  a medial meniscus repair at the same time as my ACL surgery. However, as I had a horizontal tear in the cartilage in the ‘red’ blood vessel zone, it just required a stitch, so I’m not sure it’s added that much more to my recovery time (that’s based on zero expert opinions, btw).

14. The physio protocol is impressive

I knew that ACL repair was common but it hadn’t occurred to me how well-established the ACL recovery protocol would be. With goals and exercises for each phase, if you’re a person who likes to have something to aim for and a bit of a tick-list to get through, you’ll like the structured approach to the physio.

15. Having ACL repair surgery is totally worth it

acl repair surgery
In a time not too far away, I hope to get back to some volcano hiking…

I was told that I could live without having surgery and many people function happily without having their ACL in place. However, as my physio said, that’s fine for people with a desk job who maybe go to the gym a couple of times a week. That’s certainly not me.

At only 40 years old, and with one eye always on the next adventure, I wasn’t prepared to live a life limited by forward-facing, even-surface activities. I want to climb more volcanoes. I want to swim with whale sharks again. And if I ever find myself having to outrun an ostritch in the dessert (look, strange experiences tend to find me), I’d like to know my knee has my back.

Mentally, I already feel better knowing that my knee bone’s connected to my thigh bone (ok, not necessarily anatomically correct, but there’s a song in there). Knowing that in time I’ll be able to get back to all the adventures I’m used to, I’m 200% happy I went ahead with the surgery.

If you want to hear my busting my knee story, you can read it here.

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knee surgery for acl in hospital

20 thoughts on “15 Surprises From My ACL Repair Surgery – What They Don’t Tell You”

  1. Thank you for sharing. I’m 15 days into my post-surgery recovery. I came across your article googling for compression sleeves.

  2. Hi Jo, thanks for the insight and pics of your surgery. My 15yr old sustained a complete rupture of ACL 3 weeks ago at football match, was kicked in the front of the knee hyperextension hearing the pop and feeling the pain. I knew it wasn’t good from the side lines. He plays for 3 different teams so very physical. The day he did it he had xray and had and assessment in ER they said no breaks so we went on our merry way. He recovered o.k the limp went away minimal pain, walking o.k. went to a training session (nobody said he couldn’t we didn’t know he was walking around with no ACL) light training no problem. Next day went to play a match came down in the second. State team so have the professionals on site. Did an initial assessment and the physio stopped and said prepare for the worst and hope for the best, go get MRI sent him home iced strapped and on crutches. That was a week ago. He’s off crutches, has started an intense physio prehab (6 weeks) to keep fit and build more strength in the other bits of his knee until he decides if surgery is his option. This allows for better recovery post surgery and initial trauma to settle, also building confidence in him and his knee. Thought being, his knee will be optimal condition from the start. An orthopaedic sports surgeon has been over his scans and has said surgery or non surgery are both options and he can get back to playing same level without surgery with intense physio. At his age they worry about further knee damage to growth plates etc drilling etc in a young knee. I wish there was a definitive answers and a choice we didn’t have to make pros and cons for both. He’s travelling overseas for a week and at the moment walking normally aparat from some swelling and pain from a small fracture it turned out he had. I would suggest definitely seek the opinion and support of a good physio prior to surgery. A long road, but I guess a strong knee going in at any age is a stronger knee coming out for optimal post surgery recovery and rehabilitation. Certainly if your young and sports, being active is your thing. At any age it’s a devastating injury with a long recovery and lot of effort needed with or without surgery.

    • Hi Tania, I’m so sorry about your son and also that the doctors missed the diagnosis at the beginning (including the fracture!) It’s such a tricky choice, especially for someone so young. A good physio is definitely going to be the best place for advice. I wish you both luck.

  3. Thanks for posting your journey!!! I stumbled upon your post four weeks post-op, and I’m still in awe of the gadget you had in the hospital. My family and I lived in the UK for four years and loved every minute. I had to be pushed while crying to leave:(. Everyone’s journey with ACL and Meniscus tears pulls me in. I’d never had any problems with my knees other than arthritis from dance. Then the POP I heard and felt while skiing was crazy. Now I am 4 weeks post-op, and I hate life. I’m hypermobile, usually with a -17 on my good leg, and have reached a -5. The bending is where I feel like my knee is splitting apart as I white knuckle it thru the pain. This was my 32nd surgery, and the rehab was the worst. It’s hard to self-induce pain, yet that is expected. I’m trying hard to find the light at the end of the tunnel, and every day, it’s a battle. Thanks for your story😊

    • That gadget I had still terrifies me. Wow, 32 surgeries! I can’t even imagine but clearly you have the grit to get through. Keep going Tierney.

  4. Hi Jo, this time last week I had never heard of my ACL. And now I have destroyed it in a skiing accident. Thank you for your story, it gives me hope that there’s light at the end of the tunnel.

    • Hi Caroline, ouch! I also was very unaware of my ACL until I broke it. Good luck with your recovery and getting to the end of that tunnel – it does exist.

  5. Hi, thank you for posting your journey on here. I’m 1 day post op from torn ACL. Day 1 was rough due to nausea and can keep pain meds down. Better today, but no weight bearing due to the nerve block they placed. It lasts 12-18 hours and then You get your feeling back. I recommend the nerve block but it won’t take away the pain behind your leg. So meds are necessary. Also would recommend a doctor giving you nausea suppositories, so you don’t throw them up.

    • Hi Charity, I took the nerve block also and would recommend it. I also had some nausea with the pain pills, but no vomiting. I hope you get back up on your feet (literally) very soon.

  6. Just had surgery for a ruptured ACL and meniscus torn at the root. Crutches with no weight bearing for six weeks! It isvery refreshing to read your honest account, which I keep rereading! Just helps to know this isn’t forever.
    Thank you!

  7. Thank you! I completely tore my ACL on a fabulous hike in Maui 6 weeks ago. When you talked about the moment…I knew something went terribly wrong. My hubby tried to get me right up and I put a little weight and was like…nope…my knee is NOT supposed to do that. When we returned from our Hawaii trip the Ortho doc told me that I had the complete tear and that I could still go on our scheduled RV road trip for 5.5 weeks. I’m due to go back to my doc this week to find out what we’re going to do. I would love to not to have to go through surgery…I’m a teacher and don’t want to miss school so much. I also want to be able to go on pretty big hikes in the future. Thank you for sharing a real view of this situation.

    • Hi Kelli, I loved Hawaii – sorry you injured yourself there! Perhaps if you work really hard to strengthen the surrounding muscles, you’ll be able to skip surgery? I hope you get whatever treatment you want and need.

  8. Indiana Jo, thank you so much for your posts and website. I’m going in for ACL and meniscus surgery on Monday and this is helping me big time! Not only do I feel like I can be a bit more prepared for the eventualities (whatever may happen) but it’s also great to see someone who is a similar age who has gone through it. So many posts are from younger athletes. I’m not an athlete, but active and not prepared not to pivot, run, jump and enjoy life with instability. Well done on your journey, you’re an inspiration!

    • Hi Sophie, I felt the same – younger athletes who literally bounced back. Happy to help and hope the surgery went well! PS: thanks for the kind comments.

  9. I just found out I have an acute ACL tear so I will be meeting with a surgeon in a couple of weeks. I work in a OR cleaning the room after the surgeries so I know what goes on during the surgery. Thank you for the information of how it was for you. It will help me get through it!

  10. I go to the knee doc tomorrow to discuss my upcoming acl surgery. This post, while making me queasy (I’m clearly far more of a wimp than you) was actually quite informative and for that I thank you!


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