Wound Care

• Remove Ace bandage and soft dressing in 2 days
• You will have a Prineo (mesh dressing) or dermabond glue in place.
• Keep Prineo dressing or glue in place.
• You may shower 2 days after 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

• You will be provided with ice packs on the day of your surgery. 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.
• 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.

Braces

• With a Tibial Tubercle Osteotomy you will be placed in a post-operative brace. This brace will be open from 0-90 degrees for the first 2 weeks. Week 2-4 you will be allowed to progress to full passive range of motion. Active knee extension (straightening the knee with your own muscle) and straight-leg raises are NOT permitted until the bone has healed (bony union), typically 6 or more weeks and when cleared by Dr. Pettit, because the pull of the quadriceps can displace the tubercle fragment. Passive and gravity-assisted motion are allowed earlier as directed.
• You will have a bulky dressing initially which can be removed after 2 days.
• Please wear TED compression stockings for 1 week.

Crutches & Weight bearing status

• Following a Tibial Tubercle Osteotomy, you will be heel touch (gently place the foot down) for 6 weeks. Keep the Brace locked in extension while heel touch weight bearing.

Physical Therapy

• Formal physical therapy will be ordered by your orthopedic surgeon in the form of a written prescription upon discharge from surgery. You will also receive a therapy protocol form. Following a Root Repair you should start formal physical therapy within 2-5 days. The prescription and protocol should be given to a physical therapist of your choice so you can begin your program as directed under close supervision of your surgeon.
• Until you begin working with a therapist, you can do some exercises at home, such as: quad sets, gentle passive flexion and extension, and calf pumps (no straight-leg raises or active knee extension until Dr. Pettit clears you) (see pictures below). You may begin these exercises the day following your surgery.

Pain Control and Medications

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 any questions or concerns about narcotic strength medications, please contact our office prior to your surgery for further discussion.

Nausea

• We can provide you with an anti-nausea medication, Ondansetron, as narcotics can also cause nausea. If you are having significant nausea please contact our office for a prescription

Non- Steroidal Anti-Inflammatory Medications:

• Recommend avoiding ibuprofen and nsaids for 4 weeks post-operatively

Blood Clot Prevention

• If you can take Aspirin without any difficulty and are NOT CURRENTLY on any anticoagulation, then you should take Aspirin 81 mg Twice Daily for 4 weeks, starting the day after your surgery. If you were on 81 mg of Aspirin prior to surgery please resume this dose after 2 weeks.

Driving

• In general, you can resume driving after 3-5 days after your operation, when you have full control of your arms and legs and you are pain free. Do not drive if you are still on narcotic medication.

Return to Work

• You may return to work as soon as you are comfortable and able to safely weight bear without crutches. This typically will occur 1–4 weeks post-op, depending on your job type. Return to work notes can be obtained at your first post-op appointment.

Follow-up Appointment

• Your first post-operative appointment will be scheduled 10 – 14 days following your surgical procedure. Typically dissolvable sutures are used during surgery, and do not need to be removed. 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.