Knee Replacement Surgery: How to Prepare

Preparing for knee replacement surgery, also called knee arthroplasty, begins several weeks beforehand with optimization of certain underlying health conditions, arranging for help at home after the surgery, and in some cases, attending a pre-operative education and/or exercise class.

These steps may not seem all that critical, but proper preparation for knee replacement is a key element of the procedure's outcome. There are also some logistical elements of your surgery that you should be aware of so you are prepared for your operation day.

Location

Knee replacement surgery takes between one to two hours to complete and is usually performed in a hospital. Less commonly, it's performed in an outpatient surgical center.

Upon arrival at the hospital or surgical center on the day of your surgery, you will first go into a small room within the pre-operative area. A nurse will check your vital signs and place a peripheral IV.

When the time comes, you will be brought to the operating room (OR) on a gurney. The room will be equipped with a surgical table, monitoring equipment, large overhead lights, and other standard OR items, as well as several trays of surgical tools specific to your procedure.

Be aware that many of these tools are quite sizable and, while they may resemble items found at a hardware store, are sterile precision instruments.

You will see several staff members busy preparing you and the team for the procedure.

What to Wear

For the day of your surgery, your surgeon will likely advise the following:

• Arrive at the hospital wearing comfortable, loose-fitting clothes. (You will change into a hospital gown in the pre-operative room upon arrival.)
• Leave all jewelry and other valuables at home.
• Do not wear contact lenses on the day of your surgery.
• Avoid wearing nail polish or skin products including deodorant, perfume, cream, and makeup.

You will be asked to shower the night before and the morning of with antibacterial soap.

Food and Drink

Prior to knee replacement surgery, patients are generally advised to not eat or drink anything after midnight on the eve of their surgery. The exception is that you may be able to take your morning medication with a small sip of water.

Be sure to check-in with your surgeon, though, as these instructions can vary based on the type of anesthesia you are undergoing.

Medications

It's important to tell your surgical and anesthesia team all the medications you are taking, including:

• Prescription drugs
• Over-the-counter drugs
• Supplements, like vitamins or herbal products
• Recreational drugs

About a week prior to surgery, your surgeon will advise you to stop certain medications. These usually include:

• Any nonsteroidal anti-inflammatory drugs (NSAIDs)
• Any herbal or dietary supplements and vitamins

If you are taking aspirin or a prescription blood thinner, such as Coumadin (warfarin) or Xarelto (rivaroxaban), your anesthesiologist along with your primary care doctor or specialist doctor will tell you how and when to stop these medications.

What to Bring

Unless you are having an outpatient knee replacement surgery, you can expect to stay in the hospital for about one to three days.

You will need to have someone drive you home from your procedure, and that person should be sure to bring your walker with them.

In order to prepare for your hospital stay, you should bring these items with you on the day of your surgery: 

• Your insurance card and driver's license
• Loose-fitting, comfortable clothing and comfortable rubber-soled shoes with a back to leave the hospital in
• Personal care items, such as underwear, toothbrush, hairbrush, soap, eyeglasses, contact lenses, hearing aids, and a cell phone charger
• Comfort and entertainment items such as a book, tablet, or a small pillow. Your hospital room will have a television and a phone.

Pre-Op Lifestyle Changes

In order to ensure a successful outcome and minimize your risk for complications, your surgeon will likely advise you on making various lifestyle-related changes prior to surgery.

These lifestyle-related changes often include:

• Stopping smoking, usually at least two weeks prior to surgery
• Losing weight, if obese
• Optimizing any underlying health conditions, especially diabetes mellitus

To prevent bacteria from getting into your blood and infecting your new artificial knee joint, your surgeon will also advise you not to have your teeth cleaned within two weeks of having your surgery.

In preparation for your return home after knee replacement, your surgeon will likely recommend the following:

• Ensure you have someone lined up to assist you with personal care (e.g., bathing) and household chores (e.g., laundry and grocery shopping) for at least one week.
• Even though you will be able to go up and down stairs after surgery, consider making a temporary bedroom on the first floor if applicable (especially if you are worried about falling).
• Make pathways within any crowded areas of your home.
• Remove any fall hazards within your home, such as throw rugs or electrical cords lying on the floor.
• Install handrails on your stairways and in your bathroom.
• Rent a shower chair and raised toilet seat.
• Purchase a grabber device to reach items on your own, a long-handled shoehorn, and a sock aid (a tool that helps you put socks on easily).

Education and Exercise Program

Your surgeon may ask that you participate in an education and exercise program prior to surgery. Research suggests that such a program can reduce your hospital stay and improve knee functioning after surgery.

The exercise portion of the program usually starts with simple range-of-motion exercises. It will then progress to strengthening exercises to help prepare your muscles and knee for the joint replacement surgery.

Some of these preparatory exercises include:

• Heel slides to improve your knee flexion range of motion
• Short arc quad exercises and quad sets to strengthen your quadriceps muscles (located on the top of your thigh)
• Straight leg raises to strengthen the muscles around your hips and knees
• Prone hang exercise to increase knee extension range of motion
• Seated hamstring exercises to improve the strength and function of your hamstring muscles (located on the back of your thigh)

A Word From Verywell

Being well prepared for your knee replacement operation will not only help ensure a smooth and successful recovery, but it can also help ease your mind and calm any nerves you may have going into surgery. That said, besides engaging in the above preparatory strategies, do not hesitate to bring up any last-minute questions or concerns with your surgeon. You will want to feel as comfortable and as informed as possible before the big day.