Joint Replacement Surgery
Joint replacement can help relieve pain and enable you to live a fuller, more active life. If you and your orthopaedic surgeon have decided that you are a good candidate for joint replacement, you are in good company: In 2011, almost 1 million hip and knee replacement surgeries were performed in the United States, making it one of the most common orthopaedic procedures performed today.
Before joint replacement surgery, you will need time to prepare, both physically and psychologically. Planning ahead for the challenges of surgery and recovery will help ensure a more successful outcome. This article includes some practical tips to help you get ready for your joint replacement surgery.
Learn About the Procedure
Talk to your doctor. Learn what to expect before, during, and after surgery. Your questions may include:
- What is the process for being admitted to the hospital?
- What type of anesthesia will I receive?
- What type of implant or prosthesis will be used?
- How long will I stay in the hospital?
- How long will my recovery take?
- How will my pain be managed after surgery?
In addition, do not hesitate to voice concerns or speak up if you do not understand something about your treatment. Total Joint Replacement: Questions Patients Should Ask Their Surgeon can help guide you in your discussions with your doctor.
Assemble Your Personal and Medical Information
During the weeks before your surgery, many people will ask about your insurance coverage, medical history, and legal arrangements. You may feel that you are answering the same questions over and over again, but this repetition is necessary to meet quality assurance and medical insurance guidelines.
When you have a quiet moment, take a few minutes to put together a careful list of your personal and medical information. This will help speed the process and ensure that you provide your healthcare team with all the critical information needed for a successful surgery. Be sure that your list includes the following:
- The name of a family member or friend who will come with you to doctor appointments, stay with you in the hospital, and help you to remember healthcare instructions.
- Names, addresses, and phone numbers for all the doctors you currently see and your reasons for seeing them.
- Any medical conditions or health problems you have, such as diabetes, asthma, anemia, or high blood pressure. For a checklist of health conditions and other important medical information you should share with your doctor, read: Preparing for Surgery: Medication Safety Checklist.
- Any previous operations you have undergone, even those not related to your current problem.
- Any medications you take on a regular basis—along with their dosage and frequency. Do not forget to include vitamin and mineral supplements or other over-the-counter medications you take regularly. Your doctor may advise you to stop taking certain medications or supplements a week or two before your surgery. Read to help guide you in this process.
- Any allergies or adverse reactions you have had to drugs or anesthesia in the past. Provide the name of the drug, why you were taking it, a description of your reaction and when it occurred.
- Your dietary restrictions and food allergies.
- The name of your insurance company(s), along with the plan or group number and contact information. Be sure to bring your insurance card(s) to the hospital with you.
- Any advance directives you have made, such as a living will or durable power of attorney. Bring a copy of the legal documents with you to the hospital.
Get in Shape for Surgery
Getting in the best physical shape possible before surgery can lessen the chance for complications and shorten your recovery time.
- If you smoke, cut down or quit. Smoking affects blood circulation, delays healing and slows recovery.
- Eat a nutritious, well-balanced diet. If you are overweight, there will be more stress placed on your new joint. In some cases, your doctor may recommend a weight loss program before surgery.
- If you drink, do not consume any alcohol for at least 48 hours before surgery.
- If you use any other types of controlled substances, tell your doctor. Narcotics and other drugs can cause complications and impact your surgery.
- Ask your doctor about exercises you can do before surgery. If you are having a hip or knee replacement, strengthening your upper body will make it easier to use crutches or a walker after surgery. Isometric exercises can help maintain the strength of your leg muscles. In addition, ask about the exercises that will be prescribed after surgery. If you become familiar with the exercises now, you will be ready to perform them after surgery.
Plan for Your Homecoming
Joint replacement is major surgery and your recovery will take several weeks, but there are steps you can take now to make your time at home safer and more comfortable:
- If you live alone or have special needs, consider going to a specialized rehabilitation facility after discharge from the hospital. Your doctor can suggest appropriate places to consider. Although you may not be able to make a reservation at the facility, you can tour it and meet the staff before your surgery. This familiarity will make you feel more comfortable when you arrive at the facility.
- Arrange for someone to drive you home from the hospital and stay with you for several days after your surgery.
- If you do the cooking, make double batches of everything for a week or two before your surgery. Freeze half, and you'll have two weeks of ready-made meals when you get home. If you do not cook, stock up on ready-made foods that you enjoy.
- While you are in the kitchen (and in other rooms, as well), place items you use regularly at arm level so you do not have to reach up or bend down.
- Borrow a walker or pair of crutches to see how well you can maneuver through your home. You may need to rearrange furniture or temporarily change rooms (make the living room your bedroom, for example).
- Remove any throw or area rugs that could cause you to slip. Securely fasten electrical cords around the perimeter of the room.
- Consider modifying your bathroom to include a shower chair, gripping bar, or raised toilet seat.
- Shop for things that will make your life easier after surgery. Helpful items include a long-handled shoehorn, a long-handled sponge, a grabbing tool or reacher, a footstool, and a big-pocket shirt or soft shoulder bag for carrying things around.
- Place items that you use frequently (phone, remote control, radio, facial tissues, wastebasket, pitcher and glass, reading material and medications, for example) within easy reach so that you do not have to reach up or bend down.
- If you do not already have a disabled parking permit, apply for a temporary permit several weeks before your surgery. Contact the Department of Motor Vehicles, or your doctor's office may have an application form.
Prepare for Surgery
There will be several medical professionals involved in your care. As an involved member of the healthcare team, one of your most important jobs is to ensure that each professional has the information needed for proper decision-making. Another key job is to follow any instructions that you are given in preparation for surgery. In the weeks before your procedure, your healthcare team will take a number of steps to ensure that you are prepared.
- Your primary care doctor or an internist will conduct a general medical evaluation several weeks before surgery. This examination will assess your health and your risk for anesthesia. The results of this examination will be forwarded to your orthopaedic surgeon, along with a surgical clearance.
- You may need to take several preoperative tests, including blood tests, a cardiogram, and a chest x-ray. You may also be asked to provide a urine sample.
- Tell your surgeon about any medical conditions you have and about any medications you are taking. You may need to stop taking certain medications altogether, or your surgeon may recommend taking substitute medications until your surgery. Medications such as corticosteroids, insulin, and blood thinners need to be managed both before and after surgery.
- Shortly before your scheduled surgery, you will probably have an orthopaedic examination to review the procedure and answer any last-minute questions.
- On the day of your surgery, the anesthesiologist will meet with you to discuss the type of anesthesia that will be used.
- If you are planning to have any dental work done, such as an extraction or periodontal treatment, schedule it well in advance of your surgery. Due to the risk of infection, do not schedule any dental work, including routine cleanings, for several weeks after your surgery.
- Notify your doctor if you come down with a fever, cold or any other illness in the week before the surgery.
Make Last-Minute Preparations
The 24 hours before your surgery will be a busy time filled with lots of last-minute preparations. Use this checklist to make sure that you do not forget anything:
- Take a shower or bath the night before your surgery. Your surgeon may recommend an antibacterial soap or other medical wash. This will help reduce the risk of infection.
- Do not shave the area of the surgery. If shaving is necessary, it will be done in the hospital.
- Remove any make-up, lipstick, or nail polish before leaving for the hospital.
- Do not eat or drink anything after midnight the night before surgery.
- Pack a small bag to bring to the hospital. Some of the items you should include are:
- A pair of comfortable, sturdy bedroom slippers with non-skid soles
- A knee-length robe or gown
- A lightweight camisole or cotton shirt to wear under your hospital gown
- Something to read
- Copies of your insurance cards, advance medical directives, and medical history
- Any medications you take regularly
- Personal care items such as a hair brush, denture case, eyeglass case, contact lens case. Be sure to leave your cash, credit cards and jewelry at home
- A loose-fitting sweat suit or jogging suit and comfortable shoes to wear home
- Ask a family member or friend for help if you have not yet done so. Have someone check in with you daily. You'll recover more quickly if you have help instead of trying to do everything yourself.
Source: Department of Research & Scientific Affairs, American Academy of Orthopaedic Surgeons. Rosemont, IL; AAOS; May 2014. Based on data from the HCUP Nationwide Inpatient Sample, 2011; Agency for Healthcare Research and Quality.
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.