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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.

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 your doctor's appointments, drive you to and from the hospital on the day of your surgery, 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: Health Condition 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 dosages (how much of the medication you take; for instance, 50mg pills or 2 ounces of liquid) and frequency (how often you take the medication; for instance, 2 times a day, or with meals). 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 or 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. Read  Preparing for Surgery: Medication Safety Checklist to help guide you in this process.
• Any allergies or adverse (bad) reactions you have had to drugs or anesthesia in the past, such as rashes, nausea, or vomiting. 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.

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, slows recovery, and may increase the risk of infection. Learn more: Surgery and Smoking
• 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. Learn more: Obesity, Weight Loss, and Joint Replacement Surgery
• If you drink, do not consume any alcohol for at least 48 hours (2 days) before surgery.
• If you use any other types of controlled substances, tell your doctor. Opioids 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.

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 there is another barrier to caring for yourself at home, consider having a friend or family member stay with you for several days after surgery. If that is not possible, you may require a specialized rehabilitation facility following discharge from the hospital. Your doctor will work with the social work team to determine the appropriate places to consider. If you need to go to a rehab facility after surgery, this will be covered by your insurance company; these details will be worked out with the social worker before you leave the hospital. Although you may not be able to make a reservation at a specific facility, you can arrange to tour it and meet the staff before your surgery. This familiarity will make you feel more comfortable when you arrive at the facility.
• If you do the cooking, make double batches of everything for 1 or 2 weeks before surgery (if possible). Freeze half, and you'll have two weeks of ready-made meals when you get home. If you do not cook, and you are able to do so, 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.
• If possible, borrow a walker, cane, or crutches to see how well you can maneuver through your home. You may need to rearrange furniture or, if possible, 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.
• If possible, consider modifying your bathroom to include a shower chair, gripping bar, or raised toilet seat.
• If possible, shop for things that can 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, your live-in family member, or caregiver drive and 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.

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, an electrocardiogram (EKG), and a chest X-ray. You may also be asked to provide a urine sample.
• 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. See the suggested timing for having dental work before or after hip or knee replacement.
• Notify your doctor if you come down with a fever, cold or any other illness in the week before the surgery.
• Tell your doctor about any skin irritations on the limb that is being operated on, such as cuts, scratches, abrasions, rashes, or bug bites. Any break in skin integrity (the health of the skin) can increase your risk of infection, and if you have an infection, your surgery will be cancelled.

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.
• Do a good skin assessment in the mirror. Any break in the skin gives bacteria a chance to enter your body and cause an infection. Look all over your skin, including in the groin area, under the breasts, behind the knees, and under the arms. Report anything abnormal to your doctor.
• 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. If you are going to a rehab facility after your surgery instead of directly home, you will have a team of healthcare professionals monitoring you.

Source: Department of Clinical Quality & Value, American Academy of Orthopaedic Surgeons. Rosemont, IL; AAOS; February 2020. Based on data from the HCUP Nationwide Inpatient Sample, 2019; Agency for Healthcare Research and Quality.