Preparing for Joint Replacement: What Changes the Outcome

Almost everyone preparing for a knee or hip replacement focuses on the operation. In practice the operation is the predictable part. What varies between patients — and what decides the result — is what happens in the weeks either side of it.

Why preparation changes the outcome

Two people can have technically identical surgery and end up months apart in function. The difference is rarely the implant. It is muscle strength going in, general health going in, and how consistently rehabilitation is done coming out.

Muscle built before surgery is muscle you do not have to rebuild afterwards. That single fact is the strongest argument for starting exercises weeks before admission rather than on discharge.

The five things worth doing before surgery

Stop smoking

This is the most effective single change available. Smoking impairs the blood supply that wound and bone healing depend on, and it measurably raises the risk of infection and of a fracture failing to unite. Even a few weeks of abstinence helps.

Get diabetes under control

Elevated blood sugar in the period around surgery is strongly associated with wound infection. If your control has drifted, the weeks before an operation are the time to address it with your physician.

Deal with dental problems

Bacteria from a dental infection travel through the bloodstream and can settle on a new implant. Any outstanding dental treatment should be completed before joint replacement, not after.

Build strength deliberately

Quadriceps strength before knee replacement, and hip abductor strength before hip replacement, predict how quickly you regain independent walking. Ask for a specific programme at your pre-operative visit rather than guessing.

Correct anaemia

Low haemoglobin makes recovery harder and increases the chance of needing a transfusion. It is usually treatable in the weeks beforehand, which is one reason blood tests are done well ahead of the date.

Preparing the house

The first two weeks at home are far easier if the environment is sorted in advance. A firm chair with arms at a height you can rise from, a raised toilet seat after hip surgery, loose rugs and trailing cables removed, everyday items moved to waist height, and meals prepared in advance all matter more than people expect. Falls are the main early hazard, and most of them are preventable.

What recovery actually looks like

Expect swelling, bruising that spreads down the limb under gravity, and disturbed sleep in the first week. All three are normal. Bruising appearing well below the operated joint alarms people unnecessarily — it is simply blood tracking downwards.

The knee has a genuine window for regaining bend. Scar tissue matures over the first weeks, and movement not regained in that period becomes progressively harder to recover. A knee that is sore at six weeks is a much smaller problem than a knee that is stiff at six weeks.

The symptoms that need a phone call

Fever, or a wound becoming hot, red or discharging. Calf pain or swelling, or sudden breathlessness. Pain that suddenly worsens rather than gradually improving. Inability to bear weight when you previously could. These are uncommon, and each is considerably easier to treat early.

Protecting the joint long term

Tell your dentist you have a joint replacement and discuss cover before invasive work. Treat urinary, chest and skin infections promptly, because bacteria in the bloodstream can settle on an implant years later. Keep weight down, since every kilogram is multiplied through the joint with each step. Stay active but avoid impact — walking, swimming and cycling suit a replacement; running and jumping shorten its life.

More detail is set out in the before surgery and after surgery guides, or call the clinic on +91 6355 991 466.

Trusted sources and further reading

This article is general information reviewed by Dr Dev Padia. For more on the conditions and treatments mentioned, see the pages below.

• Before surgery — how to prepare at home.
• After surgery and recovery — what recovery involves.
• OrthoInfo: Preparing for Joint Replacement — American Academy of Orthopaedic Surgeons.
• NHS: Knee replacement — UK National Health Service.

The information on this website is for general guidance and does not replace a personal medical consultation. Please consult a qualified doctor about your own symptoms.