Arthroscopic Labral Repair & Biceps Tenodesis Surgery: What to Expect Before and After

By Dr. Gregory Drake

These are Dr. Gregory Drake’s official pre- and post-surgical instructions for patients undergoing arthroscopic labral repair or biceps tenodesis at Level Up Shoulder in the Chicago area.

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If you’ve been scheduled for labral repair or biceps tenodesis surgery with Dr. Gregory Drake, this page walks you through everything you need to know, from how to prepare in the days before your procedure to what your recovery will look like week by week.

Dr. Gregory Drake performs these procedures arthroscopically at Ascension Alexian Brothers Medical Center in Elk Grove Village, Ascension St. Alexius Medical Center in Hoffman Estates, Advocate Good Shepherd Hospital in Barrington, and Geneva Surgical Suites in Genoa City, Wisconsin. Most patients go home the same day. Full range of motion returns around week 13 after the surgery, and strengthening begins.

Preparation For Surgery:

Medical clearance from your primary care physician is required for all patients, ages 35 and older, and must be completed at least 2 weeks before and no more than 30 days prior to surgery. If you are scheduled to see your physician less than 14 days prior to surgery, this may result in your surgery being delayed.

If you have any underlying cardiac conditions/history, you will also be required to obtain cardiac clearance prior to surgery.

We encourage you to have your presurgical testing done at the hospital prior to seeing your primary care physician, as many primary care offices no longer perform blood work in their office.

Seven days prior to surgery, please do not take any anti-inflammatory (NSAID) medications (Celebrex, Ibuprofen, Aleve, Naprosyn, Advil, Aspirin, etc.) as this could result in increased bleeding during surgery. If you are on blood thinners these will also need to be stopped prior to surgery. Timing will need to be coordinated with the prescribing physician and Dr. Drake.

Do not eat or drink anything after midnight the day before surgery. You may use a small sip of water the morning of surgery to take your normal medications. This includes your blood pressure medicine, which in general should be taken. Consult your primary care doctor regarding medication and insulin instructions prior to surgery.

Post-operative pain medication will be sent to your pharmacy prior to the date of surgery. We recommend you pick up your prescriptions at least 2 days before surgery in the event there is a shortage of medication at your preferred pharmacy.

Post-Surgical Instructions:

There will be a big bulky dressing covering the shoulder which cannot be removed until the 3rd day after surgery. Once the bulky dressing is removed, you will see steri-strips resembling tape over the incision sites on your shoulder. You may now shower and get the steri-strips wet, however do not scrub the area and no soaking in a bath or hot tub. The steri-strips should remain intact on your shoulder until your post-operative appointment 10-14 days following surgery.

You must remain in your sling during the day and night for 4 weeks unless performing hand/wrist/elbow exercises. The sling may be removed for showering; however, your elbow must remain at your side at all times.

Hand/wrist/elbow exercises may begin the day after your surgery and should be performed 5 times per day.

Physical therapy will begin 4 weeks post operatively depending on the size of your tear.

Narcotic pain medications are prescribed if Tylenol is inadequate (Narcotic pain medications can cause constipation, so be proactive with stool softeners and laxatives). We will not refill pain medications over the weekend or after hours. Anticipate the need for medication refills.

You may drive as soon as it is comfortable to do so as long as you are off all narcotics, which is usually after about two weeks following surgery. You SHOULD NOT DRIVE while under the influence of pain medications. You may remove your sling to drive, however your surgical arm should remain at the bottom of the steering wheel.

Do not take NSAID medications (Ibuprofen, Naprosyn, etc.) or Cox-2 inhibitors (i.e. Celebrex) for 3 months following surgery unless approved by Dr. Drake.

Follow-Up:

Text Level Up Shoulder at (847-750-5255) or schedule online to book your routine postsurgical visit for 10-14 days after surgery with Dr. Gregory Drake’s physician assistant, Steve. Steve will see you at the first and second postoperative visits.

Patients will be seen by the Physician’s Assistant for the 10-14 day and 6 week postoperative appointments. Dr. Drake will see patients for the 3 month postoperative appointment.

Please call Dr. Gregory Drake’s staff at Level Up Shoulder or your physician’s office immediately with any problems or go to the emergency room if you develop:

Drainage and increased pain at the incision site

Fever greater than 101.5 degrees F

Swelling and tenderness in your legs as this could be indicative of a blood clot

Precautions For Arthroscopic Labral Repairs/Biceps Tenodesis:

Surgery to week 0-4: Remain in your sling and no active use of the arm. You may initiate hand/wrist/elbow exercises the day after surgery. These should be performed 5 times per day to avoid developing a stiff elbow. Do not place any weight in the hand.

Post-op week 4-12: The sling will be discontinued, however, there will be no active use of the arm. Physical therapy will begin for passive range of motion (PROM), meaning your therapist will move your arm for you.

Post-op week 13: You may begin using your arm for full range of motion. Shoulder strengthening will start in physical therapy. You are to continue to avoid heavy lifting until cleared by Dr. Gregory Drake.