Preparing Yourself For Hip & Knee Surgery

In England and Wales, there are approximately 160,000 total hip and knee replacement procedures performed each year.

Waiting times for patients in need of hip and knee operations on the NHS have soared recently as a result of the winter crisis which saw operations cancelled to free up extra beds to cope with increased patient demand.

It can be incredibly frustrating for patients to have their operations delayed and rescheduled. That’s why we’re seeing an increase in patients seeking a second opinion and exploring alternative treatment options. Regardless of your patient pathway – either NHS or private care – preparing for surgery is actually as important as after-care to improve your chances of a full recovery. Taking on board the guidance given to by you by doctors, nurses and specialists at your pre-assessment will help you to be physically and mentally prepared and considering your post-surgery home environment will help eliminate any set-backs to your recovery.

Mr Deepu Sethi, consultant knee surgeon and one of London Medical Concierge’s network of doctors, give his advice to patients on how best to prepare for hip and knee surgery:

1. Stick to a balanced diet – having a healthy and balanced diet before and after surgery can help to promote recovery and reduce the risk of infection. Calcium and Vitamin D both improve the strength of your bones and protein aids healing after surgery. It is important to maintain regular bowel movements before joint surgery because constipation can be a complication after the procedure, so ensure you include fibre in your diet from foods such as whole grain, fruits, vegetables, beans and lentils.
2. Get fit for surgery – The fitter you are for surgery the faster your recovery. Strengthening muscles around your joint will help ensure that you have a faster recovery and better outcome. Of course exercise can be difficult with a painful arthritic joint, but in general Mr Sethi would recommend non-weightbearing exercise such as cycling or swimming.
3. Visit your GP and dentist – If you have other medical problems such as high blood pressure or diabetes it is important to ensure that these are well controlled and stable to ensure that you minimise the risk of complications following surgery. It’s also advisable to have a dental check-up and get any problems dealt with well before your operation. There’s a risk of infection if bacteria from dental problems get into your bloodstream.
4. Book your pre-admission clinic – your hospital will invite you to a pre-admission clinic, usually around 2-3 weeks before the surgery. You will be examined to make sure you’re generally well enough for the anaesthetic and the operation. This can involve blood tests, x-rays, urine samples and an ECG.
5. Prepare your home – it is important to set up your home properly before you have joint surgery to will allow you to easily move around your house with a walker or crutches after surgery, reduce the risk of falls and maintain your hip or knee alignment. For example, you may be advised by your healthcare team specialists to ensure that hallways and rooms are free from tripping hazards, install stair railings or make sure the existing ones are secure, set up a firm chair with armrests and fit grab bars by the toilet and bath tub to help you sit/stand. I recommend moving food and clothes that you will need on a day-to-day basis to an easy height to reach. I would also advise arranging someone to stay with you for the first 72-hours after leaving hospital.
6. Get your exercise regime organised for post surgery –  when recovering from hip and knee surgery, walking and exercise is encouraged, and you will progress from walking with the support of a physiotherapist in hospital, through to walking with a stick at home for two to six weeks after the operation. Following a knee replacement, physiotherapy after surgery is especially important for a good result. Swimming can also help, although some surgeons advise against breaststroke. Following knee surgery cycling is a particularly good form of exercise. Following hip surgery it may be difficult until 12 weeks after the operation, as it’ll be hard to get on and off the bike. Sports that involve bending or twisting at the hip will be difficult for the first 4 months. These activities will make your muscles stronger, improve your endurance and help keep your joint moving. Exercising before surgery will also help you to build up your confidence and knowledge of how to exercise after surgery.
7. Stop smoking – you should stop smoking two weeks before surgery and for the time you are recovering. This will improve your circulation and your breathing which will be beneficial to your overall healing process. Ideally if you have managed to stop smoking try not start again – you know it makes sense!