How to Prepare for Joint Replacement Surgery

If you’re having chronic and bothersome pain in your joints, especially your hip or knee, a joint replacement surgery may be life-changing. However, to get the best outcomes, it may help to make a few changes to your routine to prepare for joint replacement surgery.

“Being in optimal health before an orthopedic surgery is definitely a benefit [because] it produces better patient outcomes post-op,” says Ann Marie Moynihan, RN, Director of Nursing at NYU Langone Health.

Of course, achieving “optimal health” can be a daunting task. To simplify this goal, researchers have identified the primary factors that affect surgery outcomes. Making these changes before surgery may give you the most bang for your buck when striving for better surgery results.

Tips to prepare for joint replacement

“The surgeon has to have a good understanding of the patient's medical issues,” says William Macaulay, MD, Orthopedic Surgeon at NYU Langone Health. People who have underlying conditions, such as diabetes, have higher risks of infections from surgery and other complications.

1. Quit smoking

Another group with an increased risk of infections from surgery include people who smoke. “We highly recommend that [patients] stop smoking for at least four weeks before the date of the surgery, and that they hold off until the wound is healed at two weeks,” says Dr. Macaulay.

In addition to increasing infection risk, smoking also worsens blood circulation. The nutrients in blood help with healing, so people who smoke may heal more slowly and have a prolonged recovery period after surgery.

2. Manage weight

Carrying excess weight is actually a risk factor for needing joint replacement. Once the joint is replaced, the extra weight may continue to stress the joints and cause pain or other problems. For this reason, addressing your weight prior to surgery can improve your surgery outcomes.

“If their body mass index is in the range of 35 or 40 [or more] … we'll set them up with weight reduction programs to really take a serious and regimented look at how to get them to a safer level before the surgery,” says Dr. Macaulay.

3. Manage A1C levels

Hemoglobin A1C levels are a good indicator of long-term blood sugar management. A 2014 study from Diabetes Care journal found that patients who had A1C levels above 8 percent had poorer surgical outcomes and longer length of stay in the hospital.

“To the extent possible, we want them to be able to boost up their immune system by getting that hemoglobin A1C down,” says Dr. Macaulay. Therefore, your doctor may recommend getting your A1C down to 7% or lower.

They will also want to make sure all of your other medical conditions are controlled.

4. Tell your primary care doctor

“It's important that a patient notifies their primary care provider that they will be going for orthopedic surgery,” says Moynihan. “It opens up the line of communication with [the] primary care provider and the orthopedist. If any additional testing is needed or required, they will order that recommended testing for the patient.”

For the best post-op results from your joint replacement surgery, don’t be afraid to ask questions. You, your primary care provider, and your orthopedic surgeon are a team, and together you can prepare for joint replacement surgery for the best outcomes.

“If you have any questions about how to best prepare for your hip or knee replacement surgery, I would suggest you address that directly to your surgeon and their team,” says Dr. Macaulay.