Knee Replacement Surgery: How to Prepare

Undergoing Physical Therapy in Preparation for Knee Replacement Surgery

 

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Knee replacement surgery, also called knee arthroplasty, involves removing a patient's damaged knee joint and replacing it with an artificial one. Preparation for this operation 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.

Location

Knee replacement surgery is usually performed in a hospital. Less commonly, it's performed in an outpatient surgical center.

Upon arrival on the day of your surgery, you will be taken to a pre-operative room where you can expect the following:

  • You will change into a hospital gown and place your personal belongings in a locker.
  • A nurse will check your vital signs and place an IV into your arm.
  • Your surgeon and anesthesiologist will come to the room to say hello and answer any last-minute questions you may have.

When everyone is ready, you will be taken into an operating room where you will lay on a table. Here, you will be attached to different monitoring devices.

If undergoing general anesthesia, the anesthesiologist will give you medication to put you to sleep. If undergoing regional anesthesia, you will receive either a spinal or epidural block (where you will be numbed from the waist down), or a peripheral nerve block (where the femoral nerve in your thigh will be numbed).

Type of Anesthesia

The type of anesthesia you undergo is a major decision. You will discuss it thoroughly with your surgeon and anesthesiologist and choose the type that is best for you prior to your surgery date.

What to Wear

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

  • Shower with antibacterial soap and arrive at the hospital wearing comfortable, loose-fitting clothes.
  • Leave all jewelry and other valuables at home.
  • Avoid wearing nail polish or skin products including deodorant, perfume, cream, and makeup.

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:

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.

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 to leave the hospital in.
  • Personal care items, such as underwear, toothbrush, hairbrush, soap, eyeglasses, hearing aids, and a cell phone charger.
  • Something from home to help keep you comfortable during your hospital stay, such as a book or a small pillow.

To prepare for your recovery at home after surgery, it's a good idea to do the following:

  • Purchase any items or equipment you may need (e.g., compression socks, shower chair, walker, etc.).
  • Arrange for someone to drive you home from the hospital—be sure to have them bring your walker to the hospital.
  • Ensure you have someone to assist you at home with personal care (e.g., bathing) and household chores (e.g., laundry and grocery shopping) for several weeks.

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 to not have your teeth cleaned within two weeks of having your surgery.

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:

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 want to feel as comfortable and as informed as possible going into your procedure.

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Article Sources
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  2. American Academy of Orthopedic Surgeons. (September 2018). Anesthesia for Hip and Knee Replacement.

  3. The University of Michigan. (2015). Preparing for and Recovering from My Knee Replacement Surgery.

  4. University of California San Francisco. (2020). Preparing for Knee Replacement.

  5. American Academy of Orthopaedic Surgeons. Total Knee Replacement. Updated August 2015.

  6. Moyer R, Ikert K, Long K, Marsh J. The Value of Preoperative Exercise and Education for Patients Undergoing Total Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis. JBJS Rev. 2017 Dec;5(12):e2. doi:10.2106/JBJS.RVW.17.00015

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