Arthroplasty (Joint Replacement)

Presurgical visits

Your surgical team wants you to be in good physical health before surgery. You will have a physical exam with your primary care provider a few weeks before your procedure to see if you have any health conditions that make anesthesia risky. Your primary care provider or a specialist may also work with you to manage chronic conditions.

You may also need several tests before your procedure, including:

• Blood tests
• An electrocardiogram
• Urinalysis
• X-rays or other imaging tests

Exercise

Sometimes called “prehabilitation,” exercise before surgery may help ease your recovery and, if you’re overweight or obese, lose weight. Losing weight can reduce your risk of complications during and after surgery and may reduce stress on the new joint.

Depending on the surgery you’re having, your team may recommend prehabilitation with a physical therapist. If you do not have prehab, you can ask your surgeon about exercises that may help you prepare for surgery.

Preparing your home

Joint replacement surgery requires a few weeks of recovery. Before your surgery, you can arrange items at home and prepare in other ways to make your recovery easier. For example:

• If you live alone, ask a loved one if they can stay with you for a few days to help with cleaning, bathing, walking your dog and other household needs.
• Buy items, such as a shoehorn or grabber tool, that can help you avoid reaching or bending down.
• Clear paths in your living areas to make moving around easier.
• Cook meals in advance and freeze them.
• Move frequently needed items from upper or lower cabinets to a counter or other location where they are easier to reach.
• Remove trip hazards, such as throw rugs and electrical cords.
• Set up a temporary bedroom on a lower level if you want to avoid climbing stairs.

Before the procedure

In the weeks leading up to arthroplasty, your surgical team will give you instructions about medication use. You may need to temporarily stop certain medications, such as blood thinners or arthritis medications, before surgery.

You will also receive instructions about when to stop eating and drinking and when to arrive at the hospital.

Once you arrive, you’ll meet with the anesthesiologist. You will receive either general anesthesia, which puts you to sleep, or regional anesthesia, which numbs the area around a joint or a certain part of your body.

During the procedure

Once you are asleep or the area to be operated on is numb, your surgeon will make a cut, or incision, to gain access to your joint.

They will remove damaged bone and cartilage from the joint and replace them with a ceramic, plastic or metal prosthesis. In some joint replacements, the prosthesis is put in place using cement. In other procedures, the implant is press-fit, which means it is attached to bone that will eventually grow into the implant’s surface. This process is sometimes called cementless fixation.

The surgeon will close the incision when the new joint is in place.

After the procedure

You will be moved from the operating room into a recovery room while the anesthesia wears off. Your team will likely give you antibiotics to prevent an infection. If you’re staying in the hospital, you will move to your hospital room.

With most types of arthroplasty, your surgeon will want you to use your joint shortly after surgery. You may have physical therapy while you are still in the hospital.

Before you leave the hospital, you will have a recovery plan with specific exercises that help strengthen and improve your new joint’s range of motion. Your team will also help you with pain management to relieve any discomfort you may experience after surgery.