Preparing For Surgery

• Losing weight if you are overweight - Aim for a healthy, balanced diet and seek advice from a dietitian if you are finding it difficult to reach or maintain a healthy weight.
• Stop smoking if you are a smoker - Smoking reduces circulation, which can seriously hinder the healing process. More about smoking and arthritis.
• Talk to your doctor about any other illness or health conditions you have - Attend to any health problems that might increase the risk of complications, such as skin ulcers and dental problems.
• Tell your doctor about all the medications you are currently taking, or have taken recently, including ‘natural’ and over-the-counter medicines. Some medicines can cause prolonged bleeding during and after surgery. Sometimes your surgeon may recommend certain medications should be stopped before your operation. . Even some natural remedies, such as garlic, ginger and ginseng, can interfere with blood clotting and may need to be stopped one to two weeks before surgery. If in doubt, check with your doctor.
• Your surgeon may recommend that you ‘donate’ some of your own blood several weeks before the operation, to be given back to you if you need a transfusion at the time of surgery.

Staying active and doing regular exercise can greatly increase your chance of a faster recovery following joint replacement surgery. Do all you can to ensure you are as strong and healthy as possible. Here are some things to consider:

• If you have severe pain when walking, try exercising in water. Hydrotherapy with an aquatic physiotherapist, warm water exercise classes or swimming can all be effective ways to exercise without putting extra load or strain through joints.
• See a physiotherapist for advice about specific exercises to strengthen the muscles around your affected joint. The physio may also show you how you will do activities such as getting out of bed, walking with crutches and climbing stairs following surgery, giving you a chance to practise before you go in to hospital.
• Building upper body strength will help you be better prepared for using a walker, crutches or a walking stick during your recovery.
• Don’t forget to strengthen the muscles in your ‘good’ leg too as it will be working extra hard in the first few days or weeks after surgery.

Most hospitals hold orthopaedic pre-admission clinics. Attending the clinic usually occurs a week to 10 days before the operation. A pre-admission visit is a good opportunity to:

• Ensure you have completed all necessary paperwork and pre-operative tests, such as blood tests and X-rays.
• Discuss your estimated length of stay in hospital.
• Decide upon a likely discharge plan from hospital, including referral to the appropriate community support agencies or an acute rehabilitation centre, if required.
• Discuss with a hospital physiotherapist the exercises you will need to do after the operation, and walking aids and other equipment you may need, such as handrails and raised toilet seats.

In the first few weeks and months while you are recovering from surgery you may need help with day-to-day chores such as cooking, cleaning, bathing, shopping and errands. Before having the operation, be sure to consider the support system you have at home.

If you live alone, it might be beneficial to consider a short-stay at a rehabilitation unit after leaving hospital. Alternatively, you may be able to organise for someone you trust to move in or visit daily to help with some of these activities.

Express any concerns you might have about your ability to cope at home after your surgery with the nurse, occupational therapist or social worker at the hospital pre-admission clinic. They can help you explore all your options for receiving assistance at home, such as a home health care professional or services from local community agencies.

Well before the operation, think about ways to make your return home from hospital safer and more comfortable, such as:

• Arrange furniture to make it easier to get around. Remember you will likely be using a walker, crutches or a walking stick for the first few weeks so ensure there will be enough space to move.
• Remove rugs, wires and objects, or cover cords or cables, that may cause you to trip.
• Place things you use often within easy reach, for example the phone.
• Select chairs with arms and high, firm seats.
• Beware of bathroom hazards: place non-slip strips in the bath or shower and arrange things in the shower so they are easy to reach.
• Install hand railings wherever you might need additional support, eg. steps, shower, toilet.
• Have comfortable clothes that you can get on and off easily.
• Seek advice from an occupational therapist about additional aids and modifications to your home environment to help you be as independent as possible after surgery.