Wound Care

• You have a silver Mepilex dressing that is waterproof.
• A special gauze or glue is underneath that will remain in place until your follow up, no sutures need to be removed.
• You may shower 3 days after your surgery; be sure to pat the dressing dry afterwards. No bathing.
• Do not scrub the area; just allow water/soap to wash over you.
• Do not soak or swim until approved by surgeon.

Ice

• We recommend that you use ice on a consistent basis for the first 2-3 days to reduce post-op swelling. After that, use as necessary.
• Use a cloth between the ice and your skin- DO NOT place ice directly on skin. Do not leave ice wrap or cold therapy on for more than 20 minutes without checking your skin.

Physical Therapy

• Physical Therapy:
• Formal physical therapy typically starts between 2-3 weeks following a Latarjet. You will be given exercises to do on your own and formal physical therapy will be discussed at your first post-operative appointment. You should perform PASSIVE range of motion only for the first 6 weeks; you can begin ACTIVE range of motion at 6-7 weeks post-op, per Dr. Pettit.
• After surgery you can do some exercises at home, such as: pendulum exercises (see pictures below). You should also bend and straighten your elbow and move your wrist so they will not get stiff. You should not lift your arm using your shoulder muscles until directed by your surgeon.

Sling & Weight bearing status

• With a Latarjet, you will be placed in a sling.
• You need to wear the sling for 4-6 weeks. It should only be removed for showering and for your exercises.
• You should not bear weight with your arm or use your arm to lift anything until instructed by Dr. Pettit.
• If your sling came with a squeeze ball: please use the squeeze ball regularly to make a fist, as this will help reduce pain, swelling, and bruising. If your sling did not come with a squeeze ball: please use a pair of socks and frequently squeeze them to make a fist.

Pendulum Exercises: Perform 3 times daily for 5 minutes at a time. Gradually increase the size of the circle.

• Please see the picture below as a reference of maintaining neutral shoulder rotation. The hand of your operative arm should remain in the box, and in front of you at all times
• If you are always wearing your sling for comfort, it is important to come out of it 3-4 times a day to straighten your elbow. Be sure to move your wrist and fingers to avoid stiffness.
• Until you are more comfortable you will need some help to remove your sling. You will need to unclip the shoulder strap and the Velcro strap across your forearm. Be sure to support your arm while the sling is being removed and put back on. Do not actively move your shoulder to remove your sling.

Pain Control and Medications

You have been given a regional anesthetic block prior to your operation; this will wear off in the evening following your surgery. We recommend taking pain medication once you feel the block wearing off.

You may find it beneficial to sleep in a recliner or propped up with pillows in the days following surgery.

1. Pain Medication: Tylenol 1000mg every 8 hours and, unless discussed otherwise, you have been prescribed a narcotic pain medication (Oxycodone 5mg) to take every 4-6 hours as needed.
• DO NOT drive/use any heavy machinery, drink alcohol, make any life-changing or legal decisions (i.e. sign a will), or participate in activities that require a lot of physical skill, as narcotics may change your mental acuity. On rare occasions they may cause confusion or disorientation, we advise you to discontinue this medication should that occur.
• Narcotics can be addictive. Dispose of any excess medication at a police/fire station.
• Take a stool softener (e.g. Colace) while taking narcotic medication, as narcotics may cause constipation.  If this does not help alleviate your constipation, you can try adding miralax or milk of magnesia. Please call our office if this regimen does not alleviate your constipation.
• If you have any questions or concerns about narcotic strength medications, please contact us.
• Journavx (suzetrigine): If Journavx has been prescribed, take it in place of the Oxycodone. Start with a loading dose of 100 mg (two 50 mg tablets), then take one 50 mg tablet twice a day (every 12 hours) for two weeks. If you are not getting adequate pain control with Journavx, you may take Oxycodone instead. Do not take Journavx and Oxycodone at the same time, and avoid grapefruit while taking Journavx.
2. Anti-nausea: Zofran (Ondansetron): Take as prescribed if needed for nausea
3. Anti-Inflammatory: Unless contraindicated due to other health reasons, you have been prescribed a non-steroidal anti-inflammatory drug (Ibuprofen 800mg) for use postoperatively. If you have no personal history of adverse response to anti-inflammatories (NSAIDs), take as prescribed: Ibuprofen every 8 hours with food to help reduce swelling and pain. Do not take other NSAIDs (Celebrex, Advil, Aleve, etc) with Ibuprofen.
4. Muscle relaxer: Flexeril (Cyclobenzaprine) for muscle spasms. Take this as needed, it will make you drowsy.
5. Antibiotic: You will be given a prescription antibiotic, IF you do not stay overnight in the hospital, as a precaution for 7 days. Take twice a day with food.

Tylenol and Celebrex/Ibuprofen are the foundation for your pain control regimen

Example dosing: 1000mg Tylenol then 4 hours later 800mg Ibuprofen then 4 hours later repeat- every 4 hours alternate between Tylenol and Ibuprofen. Oxycodone as needed for breakthrough pain.

*You should not exceed 3,000mg of Tylenol or 3,200mg of Ibuprofen in 24 hours.

Driving

• Driving may resume when you are 4-6 weeks post operatively, and able to remove your sling. You may not return to driving while still taking narcotics. You must feel safe to operate a vehicle. We recommend you practice driving in an open parking lot before returning to the road. If you have to drive for long periods of time within 2 – 4 weeks after surgery, we recommend taking frequent breaks to walk and stretch, to decrease the risk of a blood clot.

Dental Work

• For the first 3 years following surgery, you will need to take one dose of Amoxicillin prior to dental procedures. Please disclose this information to your dentist and primary care provider.

Return to Work

• You may return to work as soon as you are comfortable. This depends on your job type. You will not be able to return to do any heavy lifting until 4-6 months post-op. Return to work notes can be obtained at your first post-op appointment.

Follow-up Appointment

• Your first post-operative appointment will be scheduled 7-10 days following your surgery. If you do not have a post-operative appointment scheduled, please call 513-441-5639.

*Signs & Symptoms to Immediately Report*

Call 911 and go to the nearest hospital if you are having chest pain or trouble breathing.

Call the office at: 513-354-3700 to report any of the following:

• Persistent fever (101 or greater)
• Sudden increase in pain and swelling
• Wound redness or drainage (besides blood)
• Increased skin temperature around incision
• Deep calf pain and swelling
• Severe abdominal pain