Preparing for Joint Replacement Surgery

I. What to do Before you Check In

Preparing for total joint replacement begins weeks before the actual surgery. In general, you may be told to:

  1. Donate blood –While some total joint procedures do not require blood transfusion, you may need blood before or after surgery. You may use donor blood or plan ahead to make an autologous donation of your own. You may also have a family member or friend with the same blood type as you designate a donation specifically for you.
  2. Exercise under your doctor’s supervision – It’s important to be in the best possible overall health to promote the best possible surgical experience. Increasing upper body strength is important to help you maneuver a walker or crutches after surgery. Strengthening the lower body to increase leg strength before surgery can reduce recovery time.
  3. Have a general physical examination – You should be evaluated by your primary care physician to assess overall health and identify any medical conditions that could interfere with surgery or recovery.
  4. Have a dental examination – Although infections after joint replacement are not common, an infection can occur if bacteria enter the bloodstream. Therefore, dental procedures such as extractions and periodontal work should be completed before joint replacement surgery.
  5. Review medications – Your orthopaedic surgeon can tell you which over-the-counter, prescription medications and herbal supplements should not be taken before surgery.
  6. Stop smoking – Breaking the habit is particularly important before major surgery to reduce the risk of post-operative lung problems and improve healing.
  7. Lose weight – For patients who are overweight, losing weight helps reduce stress on a new joint.
  8. Arrange a pre-operative visit – It’s important to meet with healthcare professionals at the hospital before surgery to discuss your personal hospital care plan, including anesthesia, preventing complications, pain control and diet. Bring a written list of past surgeries and medications and dosages you normally take at home.
  9. Get laboratory Tests – Your surgeon may prescribe blood tests, urine tests, an EKG or cardiogram, and chest X-ray to confirm you are fit for surgery. These tests should be performed within 14 days of the scheduled surgery in order to be acceptable.
  10. Complete forms – You will need to fill out a consent form for your surgeon confirming that you agree to have the operation and that you know the risks involved, as well as hospital forms about your past history, medications, previous operations, insurance and billing information.
  11. Prepare meals – You may want to prepare meals in advance and freeze them so they’re ready when you return.
  12. Confer with physical therapist – The physical therapist will record a baseline of information, including measurements of current pain levels, functional abilities, the presence of swelling, and available movement and strength. You will also practice post-operative exercises using either a walker or crutches.
  13. Plan for post-surgery rehabilitative care – Total joint replacement recipients may need help at home for the first few weeks, including assistance bathing, dressing, preparing meals and with transportation. If you can’t arrange for someone to help you at home, you may need to stay in a rehabilitation or skilled nursing facility. A medical social worker can assist with arrangements. Home therapy visits should end when you can safely leave the house and outpatient physical therapy should begin.
  14. Fast the night before – No eating or drinking after midnight before surgery; however, you may brush your teeth or have a few sips of water if you need to take medicines. Discuss the need to take medications such as insulin, heart or blood pressure pills with your doctor or nurse to make sure you don’t miss them.
  15. Bathe surgical area with antiseptic solution – Use antiseptic scrub brushes supplied by your health team the night before and morning of to reduce the risk of infection. Tell the nurse if you are allergic to iodine or soap. If possible, shampoo your hair. You must remove all nail polish and make-up. Do not shave your legs within 3-4 days of surgery.