paininthecalf,
As to doing the meniscal procedure and the ACL reconstruction at the same time, and if they impact on the rehab of each other, depends upon what exactly is done with the meniscus.
If the meniscus is just debrided (the torn portion removed and the edges smoothed down), then it is fine, they can both be done together. However, if the meniscus is actually repaired, then often the surgeon will elect to do the repair of the meniscus first and rehab it, then do the ACL reconstruction at a later setting. But, meniscal repairs are not very common. The debridement is much more common.
The reason for the repair not being very common is that the tear has to be at the very periphery of the meniscus (in the so called red-red zone). This is the only part of the meniscus that has any blood supply. So, it is the only part that can heal a repair. Tears in any other part of the meniscus can’t heal, so that portion of the meniscus is just removed. Which is fine, as long as the outer rim of the meniscus is left intact, that is all that is needed for the meniscus to function properly.
As to the expected progression after the ACL reconstruction, ask your physical therapist for the post-op protocol that your surgeon uses. Most of the time, the use of crutches is up to the patient (how sore he/she is). However, the surgeon and therapist do not like for a patient to limp, as that puts abnormal stresses on the limb. They would much prefer the patient walk with the crutches or a cane, than limp.
Again, ask for the protocol. It should tell you exactly what exercises you are expected to do each day, and what “milestones” you are expected to achieve (and when). Usually, at first the goals are pain reduction, swelling reduction, and regaining full extension of the knee. Extension is very important and as such is worked on first.
As to driving, that is a very personal thing. There are quadriplegics who can drive a modified car, but there are other people who cannot drive with a hangnail. The surgeon will usually give you a general idea of when you will be allowed to start driving again. But, the surgeon cannot tell you whether you are safe or not. That is something that you will have to determine yourself. We usually tell patients, that if they are married and have kids, would they feel safe putting their kids in the car and driving? Remember, that you are not only jeopardizing your own safety (by driving too soon), but the safety of everyone else on the road.
You should note, that research has been done on patients with lower extremity injuries/surgery and their reaction times in braking. If has been found that ankle injury patients will have a slower braking time for up to almost a year after their injury/surgery. It is statistically significant, but in actual driving it is something that the patient can adjust for (not tailgating, allowing more room between cars, not driving as fast, etc). The same was done for knee patients and very similar results were found.
It also depends upon whether you have an automatic or a stick shift. And which knee is being operated upon. If it is your left knee and you have an automatic, then you can probably return to driving very soon (as long as you are not taking sedating medication). But, if it is your right knee or you have a stick shift, then it is going to take longer.
You just have to be careful. If you are involved in an accident, and you are wearing a brace, limping, using crutches/cane, etc you may be cited for unsafe driving (not saying it is right, but it occurs). So, again, everyone is different, and each returns to driving at their own time. Just make sure that you are very comfortable and feel safe on the road.
As to returning to work, two weeks is pushing it a little. But, some people can do it. Since ACL reconstructions are done mostly through the ‘scope now days, the rehab is faster than it used to be (when they were done completely open). But, this is a major orthopedic surgery. And tissues only heal at their own rate.
One thing you do not want to do is compromise your outcome. You will have to control your swelling, and being on your feet for 12 hours a day, that is going to be hard. You will need to elevate your leg whenever you get a break. So, it will probably behoove you to get some thigh high TED hose to wear when you are up on your feet all say. TED hose are usually used in the hospital, to help reduce the chances of getting a DVT. They provide concentric compression on the whole leg and are a thousand times better than ace wraps. Ask the nurse who takes care of you in the hospital about getting a couple of TED hose. You may be fitted with them anyways, but if not ask about getting some. The nurse will know what TED hose are. (TED is a brand name; I think they are made by the Kendall Corporation. There are other brands of Gradient Compression Stockings.)
You will also have to make time to do your therapy. The post-op therapy is as important, if not more important, than the surgical procedure. If the post-op rehab is not done, then the surgery is for naught. So, you do not want to be so tired out, that you cannot do your exercises.
We usually recommend that patients return to half days, if at all possible, for the first month or so. But, you do have to work. You should probably speak with your surgeon about you returning to 12 hour days, just two weeks after surgery. You may be able to do it. But, do speak with your therapist and surgeon about it.
So, work hard on getting your swelling down and on your range of motion. Again, it is very important to have full extension, work on that exceptionally hard.
Good luck on your upcoming surgery. Wishing you the best.