Preparing for Joint Replacement Surgery

Before undergoing joint replacement surgery, patients will undergo a pre-operative physical examination and receive information about the surgery from nurses and physical therapists, which will be scheduled 1 week before the surgery date. This process takes about 4 hours in the hospital and includes

• Blood and urine samples (chest X-ray and electrocardiogram may also be performed)
• Consultation with a medical doctor for a health assessment and body readiness check
• Fitness assessment by a physical therapist, muscle exercise training, and practice using walking aids
• The nurse will provide detailed information about what will happen before and after joint replacement surgery, including important behaviors to follow

Stop taking medications that slow blood clotting

If the patient is taking anticoagulant or antiplatelet medications, they should consult the prescribing doctor to stop the medication at least 5 – 7 days before surgery. The pre-operative care nurse will advise on which other medications should be discontinued before surgery.

Do not shave the surgical area

Using a razor to shave can lead to infections, as it may cause skin lesions. If hair removal in the surgical area is necessary, a nurse or nursing assistant will take care of it before the surgery.

Pre-surgery anesthesiologist visit

The patient will meet with an anesthesiologist before surgery to assess readiness and receive information about anesthesia during and after the surgery.

Exercise/activity

The doctor may start an exercise program from before the surgery to after surgery, as proper exercise helps prevent blood clots in the veins, increases strength and mobility after surgery, which is important for the respiratory system, circulatory system, urinary and defecation systems. However, if there is increased joint pain after exercising or performing activities, please inform the doctor, nurse, or physical therapist (muscle soreness after exercise is normal).

Nutrition

Choose to eat enough food, covering all 5 food groups, and keep body weight within suitable limits, as excessive body weight can affect knee surgery. Avoid high-calorie foods such as high-sugar foods, sweet desserts, fried foods with high fat, fatty meats, etc. Opt for cooking methods like boiling, steaming, grilling to reduce calories and control weight.

In addition, it’s important for joint replacement surgery patients to receive vitamins and minerals from food, such as Vitamin C, Vitamin D, iron, calcium, phosphorus, and magnesium, among others. Sources include fruits, meat, eggs, low-fat dairy, fish or meat that can be eaten with bones, dark green leafy vegetables, like kale, spinach, broccoli, different kinds of beans, and whole grains.

Quit smoking

It is advised to stop smoking at least 4 weeks before surgery. Smoking increases the risk of postoperative complications, especially concerning breathing, and also diminishes wound healing capabilities.

Medications

Some medications need to be discontinued 5 – 7 days before surgery to reduce blood loss during the surgery. Examples of necessary stoppage include aspirin, anti-inflammatory drugs, blood thinners or antiplatelet drugs, and arthritis-related drugs, including suspending supplements and vitamins. All medications will be reviewed prior to surgery and the doctor will decide which medications should be stopped before surgery and which can be continued.

Infection prevention

Infections can occur both through the skin and oral cavity. Please follow these recommendations to reduce the risk of infection:

• Dental check-up before surgery. Infections can enter the bloodstream if there are cavities or during dental procedures.
• Inform your regular dentist that you have undergone joint replacement surgery before any dental work.
• Bathe, wash your hair, and clean your body before surgery.
• Avoid environments that may irritate the skin, such as sunbathing, getting scratched by animals or insect bites. If there are any wounds on the leg to be operated on, please inform the doctor.

Transportation

If the doctor approves discharge from the hospital, a relative or acquaintance must take you home. Do not drive yourself under any circumstances. It is recommended to travel in a vehicle that has sufficient space to stretch or bend your knees.