10 Things to Do Before Joint Replacement Surgery

If you are thinking about having joint replacement surgery, here are 10 things you can do ahead of time to be well-prepared for surgery and make recovery easier.

1. Quit Smoking and Other Nicotine Products

Most people know that smoking and nicotine are linked to heart and lung diseases and cancers. However, you may not be aware that smoking has a serious negative effect on bones, muscles, and joints. Those who smoke or use nicotine also have a much higher rate of post-surgical complications, including poor wound healing due to lack of oxygen in the blood and increased risk of infection.

We can help you quit smoking and other types of nicotine (Juuls®, vapes, chewing tobacco) with our Breathe Easy Quit Smoking Program. This in-person class encourages you to make lifestyle changes that make quitting easier, prepare you for your quit date, and help you manage your stress after quitting. If you can’t attend the class, call the HelpLine to speak with certified counselors who specialize in all forms of tobacco cessation.

2. Get Your Blood Pressure Under Control

If you have high blood pressure, it is important to get it in a healthy range before surgery. Ask your surgeon or primary care provider what you should aim for and how to manage any medications you are taking. If your blood pressure is not controlled, your surgery could be delayed.

3. Achieve a Safe and Appropriate BMI

Body mass index (BMI) is a measurement of your height-to-weight ratio. Having a safe and appropriate BMI before surgery helps get your body ready to take on the stress of surgery and recovery. Our orthopedic surgeons want you to be able to use your replacement joint to its fullest potential, avoid follow-up surgeries, and increase the lifetime of your new joint.

Patients with a high BMI may be at an increased risk of medical and surgical complications, including wound infections, pneumonia, blood clots, and heart attack. Talk to your orthopedic surgeon about an appropriate and safe BMI goal prior to surgery.

4. Make Sure Your Diabetes is Well-Managed

If you have diabetes or prediabetes, it is important to make sure your blood sugar is under control. Elevated blood sugar can increase your risk of complications like infections, poor wound healing, and slow recovery time. It takes time to get your blood sugar under control, so now is the time to work with your diabetes provider so that it is well-managed in time for surgery.

In addition to blood sugar, it’s important to know your A1c. A1c goals may vary depending on a person’s circumstance. For example, the Endocrine Society’s clinical practice guidelines for elective surgical patients is an A1c below 8.0%. Whereas the American Diabetes Association’s A1c goal for most adults is 7.0%. For your safety, your surgical team will individualize your A1c goal. Be sure to know your surgeon’s A1c requirement (typically below 7.5% prior to surgery) because a high A1c can cause your surgery to be delayed. If your A1c does not meet your surgeon’s requirement and you are not able to get in for a timely visit with your primary care provider, Sauk Prairie Healthcare can help.

5. Start Pre-Operative Exercises

Many patients with arthritis favor their “good” joints, which causes the arthritic joint to weaken. This weakness may interfere with recovery, so it is important to be as fit as possible before a joint replacement surgery.

Your orthopedic surgeon or healthcare team may recommend specific exercises to complete or avoid. Don't forget to strengthen your entire body, not just your legs.

6. Eat a Healthy Diet

Your body uses nutrients from a healthy diet to prepare for surgery, heal better after surgery, and fight infection. Make sure to eat a variety of nutritious foods each day. A balanced diet includes meat or protein-rich foods, whole grains, fruits, vegetables, and dairy products.

• Protein can help you heal. Good sources are cottage cheese, fish, meat, poultry, eggs, tofu, nuts and nut butters, seeds, and beans.
• Whole grains give you nutrients that are beneficial for overall health. Try incorporating whole-wheat flour, bulgur (cracked wheat), oatmeal, and brown rice into meals.
• Fruits and vegetables will give you vitamins and minerals needed to heal. Examples include oranges, strawberries, grapefruit, cantaloupes, tangerines, red and green bell peppers, broccoli, potatoes, tomatoes, and cabbage.
• Dairy products build and maintain strong bones. Dairy foods include milk, cheese, yogurt, and fortified soy alternatives.

While there’s no special diet that will heal your incision, studies have found that healing takes longer in people who follow a poor diet. A poor diet is one that is low in calories and important nutrients. Limit foods that are high in fat, sugar, and salt like doughnuts, fried foods, candy, and regular soda.

7. Schedule Dental Work

After a joint replacement surgery, you will need to wait three months before you can have any dental work or cleaning. If you can, schedule your dentist appointments prior to surgery. All dental issues must be taken care of before your procedure.

If you do need dental work after surgery, you will need to take antibiotics to help prevent an infection in your joint. You can contact your orthopedic surgeon regarding an antibiotic if your dentist is not comfortable prescribing them for you.

8. Prepare for Daily Activities

You will need help at home for the first several days or weeks depending on your progress. Ask a friend or family member to help you with meal preparation, transportation to appointments, assistance with bathing and dressing, and medication management.

Home health may also be an option to have services like physical therapy come to your home. Your orthopedic surgical team can help arrange this, if necessary.

Preparing meals ahead of time can reduce the need for extra help. Cook and freeze meals in single-serving portions or stock up on freezer dinners that are easy to reheat.

9. Get Your Home Ready

Having your house ready ahead of surgery can help you focus on recovery after you leave the hospital. Prepare your home by:

• Picking up throw rugs and tacking down loose carpeting
• Removing electrical cords and other tripping hazards from walkways
• Installing night lights in bathrooms, bedrooms, and hallways
• Installing a railing along a staircase, if you don't have one already
• Rearranging furniture if you plan to temporarily change rooms (e.g. make the living room your bedroom)
• Preparing the bathroom with items like a bath seat, grip bar, or raised toilet seat
• Putting regularly used items at mid-level so you do not need to reach up or bend down

10. Confirm Coverage with Your Insurance

Even though the hospital will contact your insurance company for pre-authorization and approval, you should also contact your insurance company to find out about out-of-pocket costs, deductibles, or co-pays for which you will be responsible.

If you do not have insurance and worry that you may not be able to pay in full, we may be able to help. We provide financial programs to patients based on eligibility criteria. In addition, we may be able to help you identify other available resources or work with you to arrange a manageable payment plan.