How should you prepare for knee replacement surgery?

Published: May 21, 2021 | Updated: May 24, 2022

Preparing for knee replacement surgery may feel intimidating. Did you know that every year, more than half a million people have knee replacement surgery? Your doctor’s office will give you a booklet and more detailed information, but here are some things to know and do before your procedure.

Overview of knee replacement surgery

The knee is the largest joint in your body, made up of bones, cartilage and ligaments. When the cartilage starts wearing away, the knee becomes stiff and painful. This is called arthritis. Eventually, bone starts rubbing against bone, causing even more pain and loss of movement.

Knee replacement surgery replaces the painful joint with a mechanical one. During knee replacement surgery, the surgeon will make an incision on the top of your knee. The ends of the bones are shaped and trimmed, then replaced with metal and plastic pieces. A plastic button may be placed on the back of the kneecap if the cartilage is worn out there. The new knee comes in different sizes. Your surgeon will decide which size is the best fit for you.

The incision will be closed with staples, stitches and/or glue. During your recovery process, your pain should be decreased and your knee function should improve. Your surgeon will do the easy part; it’s up to you to do the rest — physical therapy and following your surgeon’s instructions.

Before surgery

Choose a coach

This could be a spouse, family member, friend or neighbor. The coach is someone who can help you. Your coach will:

• Help you prepare for surgery.
• Go with you to some or all of your visits to the doctor.
• Help you get your home ready so you will be comfortable after surgery.
• Remind you to do your exercises before and after surgery.
• Help you at home with exercise, household chores and other tasks.

Check your home

• Move furniture, rugs, extension cords and clothing to make it easy for you to get around. Consider setting up a temporary bedroom on the first floor or installing safety railings in the bathroom.
• Make sure everything you need is within easy reach.
• Stock the pantry and freezer.
• Clean your home, put clean sheets on the bed and do the laundry.

The days before and day of surgery

• Follow your diet instructions the day before and morning of surgery. Drink plenty of fluids the day before surgery.
• See your primary care provider and any other doctors you see regularly to make sure they clear you for surgery. This is an elective surgery, and we want you to be in the best shape possible before surgery.
• Pack a bag if you are staying at the hospital.
• Bathe with soap given to you during your preadmission testing and follow the instructions.

What to take to the hospital with you

• A walker if you have one (this can stay in the car until you are assigned a room after surgery)
• Clothes to wear after surgery: Choose loose shorts, T-shirts, baggy sweatpants. You are going to be doing lots of therapy and movement, so we want you to be in comfortable clothes.
• Supportive shoes (not slip-ons)
• Personal care and hygiene items including medications and eye glasses
• Living will or power of attorney papers, insurance cards and identification; method of payment if you have a co-pay (check, cash, credit or debit card)

Upon your arrival at the hospital

• Visit registration where your paperwork will be completed and your information confirmed.
• From there, you will go to the preoperative area to prepare for surgery.
• You will talk with the surgeon and anesthesiologist.
• When it is time, you will go to sleep and the surgery will be performed.
• Your family will be kept informed as the surgery progresses and is finished.

 After surgery

• You may wake up with an IV, oxygen and pulse oximeters to check your oxygen level, a foot/leg pump and compression hose (these help with circulation).
• It is important to use your spirometer (deep-breathing tool) every hour to help your lungs recover — the staff will show you how to use it.
• You may start out on a liquid diet, then slowly start eating regular foods as you can tolerate them. It’s important to drink lots of liquids!

When you begin to have pain, be sure to tell your nurse. Don’t wait until the pain worsens, because it will take a little time for the medication to begin to work. Do not attempt to walk without assistance. Call a nurse if you need to get up. A therapist or nurse may visit you and get you up and moving. The sooner you start moving, the better off you will be!

Day of surgery and until you leave the hospital

• You may have blood drawn once a day (usually at night or early in the morning) so that your doctor can see the lab results.
• A physical therapist should see you twice a day until you have reached your goals.
• Your nurse may remove any tubes and drains that remain and change your dressing.
• Your care team would like to help you get dressed and sit in a chair for meals.
• A care manager or social worker will visit you and discuss your plans for going home and what medical equipment you might need.
• Your nurse will help you understand your home care instructions and answer any questions you have.

Preventing complications

• Hygiene: Keep your incision site and your hands clean.
• Do your prescribed exercises.
• Elevate your legs as much as possible.
• Take pain medication if you need it.
• Use your spirometer.
• Drink plenty of water.
• Get up and move as often as you can.
• Take your stool softener.

Sign up for Norton MyChart

We also offer online seminars to help you understand what will happen before, during and after surgery. Sign up here.

You can find more information and resources here.