Orthopedics Hip & Knee Surgical Procedures Improving Success of Hip & Knee Replacement Surgery By Jonathan Cluett, MD twitter linkedin Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. Learn about our editorial process Jonathan Cluett, MD Medically reviewed by Medically reviewed by Stuart Hershman, MD on October 05, 2020 linkedin Stuart Hershman, MD, is a board-certified spine surgeon. He specializes in spinal deformity and complex spinal reconstruction. Learn about our Medical Review Board Stuart Hershman, MD Updated on December 30, 2020 Print The risk of complications after hip replacement and knee replacement surgery can be reduced with a number of lifestyle strategies, including weight control, avoiding alcohol, and not smoking. Surgical complications can involve infections, persistent pain, inadequate wound healing, and joint stiffness. When you are considering hip or knee replacement surgery, it's important that you are ready to take the steps that can help prevent complications. 1 Weight Loss Tetra Images / Getty Images Obesity can exacerbate joint pain and can contribute to the need for joint replacement. Obesity also makes knee and joint replacement surgery riskier. People who have a body mass index (BMI) of more than 40 are at a higher risk of post-operative infection and have a higher likelihood of requiring revision joint replacement surgery. If you are overweight, it's important that you focus on losing weight prior to your joint replacement surgery. Exercise can be difficult when you have chronic joint pain, but there are ways to exercise that don't place too much stress on joints. Your doctor or physical therapist can guide you when it comes to safe and pain-free physical activity. 2 Quit Smoking GARO/PHANIE / Getty Images Smoking and tobacco products affect microvascular circulation, which has a direct impact on healing after surgery, including joint replacement surgery. Smoking increases the chance of developing wound infections, experiencing wound healing problems, and readmission to the hospital after joint replacement surgery. Quitting smoking prior to surgery can improve the outcome after joint replacement. Most surgeons recommend that you quit smoking for a minimum of six weeks, if not longer, prior to undergoing surgery—and some surgeons are starting to obtain pre-operative nicotine tests to help ensure the best possible surgical outcomes. 3 Avoid Alcohol David Silverman / Getty Images While drinking alcohol infrequently or in moderation is unlikely to lead to risks related to joint replacement surgery, drinking frequently or heavily can increase the chances of surgical complications. If possible, limiting alcohol consumption prior to elective surgery can help prevent complications. And informing your healthcare team about the amount of alcohol you consume is equally important. It is well known that people often underestimate the amount of alcohol they consume. If you are unsure of how much you drink, keep a daily log by writing down how many drinks you consume each day for a few weeks. Give this information to your health care provider to help them manage your care when you undergo surgery. Prolonged hospitalization is the most common surgical complication that affects people who consume heavy alcohol. 4 Address Anemia THOMAS FREDBERG / SCIENCE PHOTO LIBRARY / Getty Images Anemia is a condition in which you have a low red blood cell (RCB) count or impaired RBC function. RBCs are oxygen-carrying cells, and a deficiency can cause problems related to surgical healing. Anemia also increases the likelihood that you may need a blood transfusion after having a joint replacement. Causes of anemia include: Iron deficiencyKidney dysfunctionInflammatory conditions Most often, postoperative anemia can be prevented with treatment prior to surgery. The treatment for different types of anemia varies. Iron deficiency anemia is often managed with nutritional supplements, whereas other types of anemia may require medications or interventions. 5 Maintain Mental Health Jose Luis Pelaez Inc / Getty Images Mental health plays a significant role in the likelihood of a successful outcome after joint replacement surgery. People who have clinical depression are more prone to experiencing severe post-operative pain, developing surgical complications, are less satisfied with the results of the surgery, and have a higher chance of needing revision joint replacement. It is important to identify clinical depression prior to undergoing joint replacement surgery. If you are diagnosed with depression, you can get treatment from a mental health professional prior to undergoing surgery so you can optimize the results of your joint replacement surgery. A Word From Verywell The decision about whether you should have joint replacement surgery requires careful consideration. The outcomes of this type of surgery tend to be very good. However, complications can occur, and avoiding these complications should be one of your top priorities. Following these steps will help you gain some control of your risk of complications. Was this page helpful? Thanks for your feedback! Dealing with joint pain can cause major disruptions to your day. Sign up and learn how to better take care of your body. Click below and just hit send! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Alexander DP, Frew N. Preoperative optimization of anemia for primary total hip arthroplasty: a systematic review. Hip Int. 2017 Jun 7:0. Browne JA, Sandberg BF, D'Apuzzo MR, Novicoff WM. Depression is associated with early postoperative outcomes following total joint arthroplasty: a nationwide database study. J Arthroplasty. 2014 Mar;29(3):481-3. OrthoCarolina Hip and Knee Center, Charlotte, North Carolina 28207, USA. Obesity and total joint arthroplasty: a literature-based review. J Arthroplasty. 2013 May;28(5):714-21. Rotevatn TA, Bøggild H, Olesen CR, Torp-Pedersen C, Mortensen RN, Jensen PF, Overgaard C. Alcohol consumption and the risk of postoperative mortality and morbidity after primary hip or knee arthroplasty - A register-based cohort study. PLoS One. 2017 Mar 17;12(3):e0173083. Sahota S, Lovecchio F, Harold RE, Beal MD, Manning DW. The Effect of Smoking on Thirty-Day Postoperative Complications After Total Joint Arthroplasty: A Propensity Score-Matched Analysis. J Arthroplasty. 2017 Aug 1. pii: S0883-5403(17)30674-5.