In just the same way that I have been driving down the recovery time for knee arthroscopy, I have been working hard on getting patients better faster after their anterior cruciate ligament reconstruction.
One key measure is to keep the tourniquet (the band around the thigh that stops bleeding into the knee) use to a minimum. The aim is to have this on for less than a hour, and ideally for just 20-30 mins. In order to do this, I take the graft before the tourniquet goes up, and even start the arthroscopy part without it too.
The next thing is to minimise bleeding. Having blood in the knee is very painful. Hence it is useful to try to stop any bleeding inside the knee during the surgery. The conventional way of doing this is by keeping a high pressure of fluid in the knee with a pump. The clever way is to deal with each and every blood vessel as it starts to bleed. Another trick I use is to leave a surgical drain - a small pipe - in the knee for the first few hours after the op. This allows any blood to come out of the knee, so that the next day the knee is not too swollen.
Icing the knee is very useful and I recommend a "cryocuff" to all of my patients. This is great in the postoperative period for keeping swelling and pain at bay.
I use a lot of local anaesthetic both before and after the operation in order to make sure pain signals never get to the brain.
After the surgery there is a tight bandage for the first 48 hours, followed by a tubigrip compression bandage. Both of these help keep swelling at bay and speed up recovery.
All of these measures coupled with my own tailor made rehabilitation regime ensure a really fast recovery after this sort of surgery with many patients getting back to desk based work at 2 weeks.
Read all about ACL reconstruction here.