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Analysis of hepatitis C virus/classical swine fever virus chimeric 5NTRs: sequences within the hepatitis C virus IRES are required for viral RNA replication

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El-Refai SM, Brown JD, Arnold SM, Black EP, Leggas M, Talbert JC

and the C63 and C63S AMG

In my opinion, you should only consider surgery after giving rehabilitation a fair chance (at least 3-6 months) because it comes with a long recovery time, potential complications, and a very high cost
According to the FDA-approved prescribing information, tirzepatide should be injected subcutaneously in one of three designated anatomical areas: the abdomen, thigh, or upper arm
