Wound Care

• Remove dressing in 2 days.
• You may shower 3 days after your surgery; be sure to pat the incision dry afterwards.
• Do not scrub the area; just allow water/soap to wash over you.
• Do not bath or swim until approved by surgeon.

Ice

• We recommend that you use ice on a consistent basis for the first 24–48 hours. This will help reduce post-operative swelling. After that, use as necessary.
• Use a cloth between the ice and your skin. DO NOT place ice directly on skin as this may cause frostbite. Do not leave ice wrap or cold therapy on for more than 20 minutes without checking your skin.

Sling & Weight bearing status

• You will be placed in a sling.
• You need to wear the sling for 6 weeks. It should only be removed for showering and for your exercises.

Your sling or brace should hold your arm in NEUTRAL rotation with slight abduction (elbow held slightly away from your side), NOT adducted across the front of your body.

Posterior precautions: For the first 6 weeks, avoid the combined position of reaching your arm forward and across your body while rotating it inward, and do not rotate your arm inward past neutral.

• You should not bear weight with your arm or use your arm to lift anything until instructed by your surgeon.

Physical Therapy

• Formal physical therapy typically starts between 2 weeks following an Osteochondral allograft. You will be given exercises to do on your own and formal physical therapy will be discussed at your first post-operative appointment.
• If this box is checked: until you begin working with a therapist, you can do some exercises at home, such as: pendulum exercises (see pictures below). You should also bend + 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.
• If this box is checked, you should not begin pendulum exercises until instructed. You should remain in your sling at all times. It may only be removed to bend + straighten your elbow 2-3 times a day.

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

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Pain Control and Medications

Day of Surgery

• You have been given a regional anesthetic block prior to your operation. This will wear off in the evening following your surgery.
• You may find it beneficial to sleep in a recliner or propped up on pillows for the first several days after surgery.
• Some swelling and bruising can occur after surgery. Make sure to apply ice to the affected area. 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. If you are concerned about the amount of swelling or bruising, please contact our office.

Tylenol

• Take 1000mg Tylenol every eight hours. You should not exceed more than 3,000mg of Tylenol in a single day.

Narcotics

• You have been prescribed a narcotic pain medication.
• Oxycodone 5mg may be taken every 4-6 hours as needed for pain.
• 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.
• Use the medication only as prescribed. Take it with food.
• Do not drive or use any type of 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 this medication may cause confusion or disorientation, and we advise you to discontinue this medication should these occur.
• You may obtain a partial fill of this medication at your pharmacy.
• This medication can be addictive.
• Please dispose of any excess medication at any police or fire station.
• Take a stool softener, such as Colace, while taking the narcotic medication, because narcotics may cause constipation.  If this does not help alleviate your constipation, you can try adding miralax or milk of magnesia. Please contact our office if this regimen does not alleviate your constipation.
• If you have nausea following surgery we can prescribe Ondansetron, as narcotics can also cause nausea. If you experience nausea please contact our office.
• If you have any questions or concerns about narcotic strength medications, please contact our office prior to your surgery for further discussion.

Non- Steroidal Anti-Inflammatory Medications:

• Ok to take ibuprofen or other nsaids after surgery as needed. Typically 600 mg of ibuprofen (with food) every 8 hours as needed for pain.

Muscle Spasm

• Flexeril
• Patients <70 years of age will be prescribed flexeril for muscle spasm .
• Flexeril 5mg-10 mg may be taken every 8 hours as needed for muscle spasm.

Oral Contraceptive medication:

• If you are currently taking oral contraceptive medication, you may be at a higher risk for a blood clot after surgery. Please consider talking with your primary care physician or gynecologist about discontinuing this temporarily surrounding your surgery.

Driving

• Driving may resume when you are 4 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

• Please do not undergo any dental work, including cleanings, six weeks prior to surgery, and six months post-surgery.

Return to Work

• You may return to work as soon as you are comfortable. This is dependent on your job type. You will not be able to return to work with 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 surgical procedure. If you do not have a post-operative appointment scheduled when you leave following surgery, please call 513-441-5639 to make the appointment.

****Signs & Symptoms to Immediately Report****

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