Preparation for Surgery

Joint replacement surgery is a major elective surgery and can be physically, emotionally and financially draining for the patient and the family. Adequate preparation for the surgery helps to optimize the outcomes and postoperative course.

• Once you have made up your mind to undergo a joint replacement, get the date for surgery, and undergo preoperative check-ups and investigations as advised by the doctors. Final pre-anaesthesia check-ups are usually done the day prior to surgery after admission.
• Arrange adequate finances for the surgery. If you have a mediclaim policy, enquire with the hospital whether cashless facility is available for that insurance company. Intimation is sent to the insurance company and a pre-approval is obtained for the proposed surgery before admission. Arthritis is a chronic/pre-existing disease, and most insurance companies do not cover pre-existing diseases in the first two years of insurance.
• Discuss with your doctor regarding any change in your regular medications required before surgery. Some medications, like blood-thinners, need to be stopped a week before surgery. Dosage of pain medications too should be minimized. Good control of blood pressure and sugars is required before surgery. Concerned specialists should be consulted, if required.
• It is advisable to refrain or reduce smoking before surgery. Tobacco/nicotine impeded blood flow and wound healing, and increases the risks of infections and DVT. Heavy alcoholic intake (beyond 1-2 drinks) too should be avoided.
• Report any illness or fever occurring before surgery. Joint replacements should be avoided in the presence of any active infection in the body. Additional medications and antibiotics might be required in such cases.
• Maintain good local hygiene of the body and the limb to be operated. Regular baths and showers should be taken in the week preceding surgery. Your doctor may advise to use antiseptic soaps to further decrease bacterial contamination and risk of infection.
• Start doing knee exercises, as advised by your doctor or physiotherapist, before surgery. Such preoperative exercises (“prehabilitation”) have been shown to improve postoperative pain and outcomes, and also make the patient familiar with the postoperative exercises.
• Prepare your home for postoperative care. Remove any loose carpets or rugs, get walking aids such as a folding walker and stick and get a folding high commode, if there is no western commode toilet at home, or it is too low. Metal grip handles can be fitted near commode and shower to assist in transfers.
• Last, but not the least, relax! Joint replacement is not a life-threatening surgery, and major complications are quite rare after this surgery. Trust your doctor and do not worry too much. A relaxed state of mind helps in smooth recovery.