Post-Surgery Recovery: When Can I Stop Using Crutches After ACL Injury?

Post-operative issues following a left knee contusion with a left posterior cruciate ligament tear and fracture?

I was injured in a car accident on March 31st, and after an MRI examination, it was confirmed that I have a torn anterior cruciate ligament and a fracture in my left foot.
I had two "4.5; 6.5MM Syndesmosis Hollow Compression Screw Systems" implanted.
I underwent surgery on April 1st and was discharged on April 3rd.
I have a self-paid lightweight knee joint activity brace.
I had follow-up appointments on the 7th and 13th, during which the doctor indicated that I could adjust the angle to 20 degrees (on the 7th) and 40 degrees (on the 13th).
After the appointment on the 13th, the doctor instructed us to schedule a follow-up in a month.
During the first follow-up, I asked the doctor how long I would need to use crutches, and the doctor mentioned approximately 4 to 6 weeks.
After the second follow-up, an X-ray showed no abnormalities.
I specifically asked the doctor if there was a chance I could stop using crutches early, and the doctor replied that there was a possibility, but did not provide guidance on how to determine when I could stop using them.
Currently, I am using a three-point gait with the crutches, and I can walk at a speed similar to that of a normal person.
I estimate that I can apply about half of my strength with my left foot, and there is no discomfort when I put weight on it.
However, due to my lack of experience, I am hesitant to put full weight on it.
At home, I can use a single crutch (which is more convenient) without any discomfort.
Recently, I have an urgent matter and would like to know if there is a way to stop using the crutches, so I don't have time to wait until my next appointment to ask the doctor.
Therefore, I would like to inquire: 1.
How can I determine when I can stop using crutches and walk normally? 2.
Is it safe to put weight on my left foot while standing still? 3.
Can I use a single crutch at home, or is using a single crutch actually dangerous?

Mr. Li, 10~19 year old female. Ask Date: 2020/04/18

Dr. Wang Shouji reply Orthopedics

Hello, for anterior cruciate ligament reconstruction, tunnels are drilled into the bone and secured with screws.
It is advisable to wait at least two months before attempting full weight-bearing to ensure safety; avoid premature excessive loading that could lead to fixation loosening.
Engaging in muscle training can help reduce the rehabilitation period, and generally, after three months, there should be no issues as long as regular follow-up appointments are scheduled to check the stability of the ligament.
Changhua Hospital cares about your health.
Sincerely, Dr.
Wang Shou-ji.

Reply Date: 2020/04/18

More Info

After an ACL injury and subsequent surgery, the recovery process can be complex and varies significantly from person to person. It’s great to hear that you are making progress after your surgery on April 1st, and that your follow-up appointments have shown no abnormalities. Here’s a detailed response to your questions regarding the use of crutches and your recovery.

1. Determining When to Stop Using Crutches: The general guideline for using crutches after ACL surgery is typically around 4 to 6 weeks, as your doctor mentioned. However, the decision to stop using crutches should be based on several factors, including your pain level, stability of the knee, and your ability to bear weight without discomfort. A good rule of thumb is to assess your ability to walk without crutches while maintaining a normal gait pattern. If you can walk with a three-point gait (using crutches to support your weight while your injured leg is off the ground) and feel stable, you may be ready to transition away from crutches. It’s important to listen to your body; if you experience pain or instability, it’s advisable to continue using crutches until you feel more confident.

2. Weight Bearing on the Injured Leg: When it comes to bearing weight on your injured leg while stationary, it is generally acceptable to put some weight on it as long as you do not experience pain. However, this should be done cautiously. If you feel any discomfort or instability, it’s best to avoid putting full weight on the leg until you have further guidance from your healthcare provider. Gradually increasing the weight you place on your leg while ensuring you have a stable surface to lean on can help you gauge your readiness to fully bear weight.

3. Using a Single Crutch at Home: Using a single crutch can be a practical option for moving around your home, especially if you feel stable and can manage your balance. However, it’s essential to ensure that you are not compromising your safety. If you choose to use a single crutch, make sure to use it on the opposite side of your injured leg to provide adequate support. Be cautious of any uneven surfaces or obstacles that could lead to a fall. If you feel any instability or pain while using a single crutch, it may be safer to revert to using two crutches until you gain more strength and confidence.

In addition to these points, it’s crucial to follow your physical therapist's recommendations regarding rehabilitation exercises. Engaging in physical therapy can significantly enhance your recovery by improving strength, flexibility, and stability in your knee. They can also provide you with specific exercises to help you regain full function and guide you on when it’s appropriate to transition away from crutches.

Lastly, while it’s understandable that you have urgent matters to attend to, it’s always best to consult with your healthcare provider before making significant changes to your recovery plan. They can provide personalized advice based on your specific condition and progress. If you have any concerns or feel uncertain about your recovery, don’t hesitate to reach out to your doctor for clarification. Your safety and health should always come first.

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