How to Prepare for Total Knee Replacement

A patient typically has to wait 6 to 12 weeks to have knee replacement surgery. During this time, a patient can do things to help ensure a successful surgery and recovery. This page describes different ways patients can prepare for knee replacement surgery.

Prehabilitation for Knee Replacement

Evidence suggests that patients who engage in “prehabilitation”—pre-surgical physical therapy to strengthen the muscle surrounding the knee—may experience slightly less pain and better knee function after surgery. However, these reported effects do not seem to significantly affect patients’ length of stay in the hospital, medical costs, or post-surgical quality of life.¹Wang L, Lee M, Zhang Z, Moodie J, Cheng D, Martin J. Does preoperative rehabilitation for patients planning to undergo joint replacement surgery improve outcomes? A systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2016;6(2):e009857. doi:10.1136/bmjopen-2015-009857.

Commonly Required and Suggested Medical Preparations

The medical preparations described below are typical for total knee replacement surgery and other major surgeries requiring general anesthesia. A surgeon and hospital should clearly communicate any required medical preparations well before the time of surgery. Patients who have specific questions or concerns regarding medical preparations should contact their surgeons’ offices.

See Anesthesia for Orthopedic Surgery

• Cut or decrease medications. Two weeks before surgery, a patient may be asked to stop taking certain medications, such as:
  • Aspirin, non-steroidal anti-inflammatory drugs (Aleve, Advil), and other medications that make it more difficult for blood to clot
  • Steroids and other medications that suppress the immune system and therefore can increase the chance of post-surgical infection
  • Opioid pain medication to help decrease tolerance to pain medication and improve postoperative pain level
• Cut or decrease tobacco use. A patient may be told to eliminate or cut down on smoking or other tobacco use. Nicotine impedes healing and increases the risk of post-surgical infection or deep vein thrombosis, a potentially deadly blood clot in a deep vein.
• Check with specialists. Patients who have other medical conditions, such as diabetes or heart disease, may be required to consult specialists in those areas to make sure they are able to undergo surgery.
• Cut or decrease alcohol use. Patients who have more than 1 or 2 alcoholic drinks per day should tell their doctors, as heavy alcohol use influence the effects of anesthesia.
• Report illness. Patients who get sick (cold, flu, fever, herpes breakout, etc.) in the days preceding a surgery should report it to their doctors.

A patient should tell the surgeon about any medications they take, including homeopathic medications and nutritional supplements, and ask if they are safe to take before and after surgery.

Commonly Required and Suggested Home Preparations

Deep bending and squatting can lead to knee injuries during the recovery period. A patient can minimize these risks by making advanced arrangements and preparing his or her home. For example:

• Arrange for a spouse, friend or other caregiver to provide meals and help around the house.
• Arrange for transportation, as most patients cannot drive for the first 4 to 6 weeks after surgery.
• Stock up on pre-made meals and toiletry items to avoid having to run errands post-surgery.
• If possible, arrange to spend sleeping and waking hours on the same floor in order to avoid stairs.
• If possible, adjust the bed height (not too high or too low) to help ease the transition in and out of bed.
• Take away or move anything that might be tripped over, such as area rugs or electrical cords.
• Make sure all stairs have sturdy railings.
• Install small rails or grab bars near toilets and in showers.
• Install a modified toilet seat; a higher seat will put less stress on the knees and make it easier to sit down and get up.
• Put a small stool in shower to avoid standing on a slippery surface.
• Have a comfortable, supportive chair with an ottoman to keep leg elevated for intervals.
• Have cold packs on hand to help alleviate swelling.
• Consider practicing using walkers, canes and other assistive devices ahead of time to ensure proficiency using them.

This list is not exhaustive. Patients may identify other ways to tailor their homes to accommodate specific needs. The goal is to avoid obstacles and activities that could lead to injuries or impede healing.