Preparing for Knee Replacement Surgery

Making the decision to undergo knee replacement surgery is an important step towards reducing pain, improving mobility and returning to the activities you enjoy.

Many patients understandably focus on the operation itself, but successful outcomes begin well before the day of surgery.

Preparing both physically and mentally for surgery can improve your confidence, make recovery smoother and help you return to normal activities sooner.

This guide explains how to prepare for knee replacement surgery and what you can do in the weeks leading up to your operation.

At a Glance

✔ Optimise your general health before surgery.

✔ Stay as active as your knee allows.

✔ Begin strengthening exercises before your operation.

✔ Arrange support at home for your recovery.

✔ Understand what to expect after surgery.

✔ Ask questions so you feel informed and confident.

Preparing for surgery is sometimes called prehabilitation.  Research has shown that patients who are well prepared often:

• Feel more confident

• Recover more quickly

• Walk earlier

• Regain strength sooner

• Experience less anxiety

• Understand what to expect during recovery

The aim is to put your body in the best possible condition before surgery.

Your overall health plays an important role in your recovery.  Before surgery it is helpful to:

• Keep blood pressure well controlled.

• Optimise diabetes management.

• Treat any active infections.

• Maintain a healthy weight where possible.

• Continue regular physical activity.

• Eat a balanced, protein-rich diet.

• Stay well hydrated.

Sometimes surgery may be delayed to allow medical conditions to be optimised, improving safety and reducing the risk of complications.

Strong muscles support your new knee after surgery.  Even if arthritis limits your activity, gentle strengthening exercises can still be beneficial.

Examples include:

• Straight leg raises

• Seated knee extensions

• Mini squats (if comfortable)

• Sit-to-stand exercises

• Stationary cycling

• Swimming or hydrotherapy

Your physiotherapist can develop an individual programme suited to your symptoms.

Many patients worry about bending their knee before surgery because of pain.  However, maintaining as much movement as possible beforehand often makes early rehabilitation easier.

Focus on:

• Fully straightening the knee

• Comfortable bending exercises

• Gentle stretching

• Regular walking

Avoid pushing through severe pain.

Making a few simple changes before surgery can make the first few weeks much easier.

Consider:

• Removing loose rugs or trip hazards.

• Placing commonly used items within easy reach.

• Preparing meals in advance.

• Arranging help with shopping or housework.

• Ensuring good lighting throughout your home.

• Organising a comfortable chair with supportive arms.

A safe home environment reduces the risk of falls and helps you recover more confidently.

Depending on your individual circumstances, you may require:

• Walking sticks or crutches

• A walker

• Raised toilet seat

• Shower chair

• Long-handled reacher

• Ice packs (RE3 Cryocuff knee brace)

• Compression stockings (if advised)

Your healthcare team will guide you on what is appropriate.

Some medications need to be adjusted before your operation.

These may include:

• Blood-thinning medications

• Certain diabetes medications

• Anti-inflammatory medications

• Herbal supplements

Always discuss your medications with your surgeon, anaesthetist or GP before making any changes.

Smoking and Alcohol

Stopping smoking before surgery improves:

• Wound healing

• Bone healing

• Lung function

• Blood circulation

• Recovery

Reducing excessive alcohol intake also lowers the risk of complications and supports healing.  Even stopping smoking a few weeks before surgery can have meaningful benefits.

Nutrition

Good nutrition provides your body with the building blocks needed for healing.

Aim for a diet rich in:

• Lean protein

• Fruit and vegetables

• Wholegrains

• Dairy or calcium-rich alternatives

• Adequate fluids

• Zinc and multi-vitamins are helpful for wound healing

If you have unintentionally lost weight or have concerns about your nutrition, discuss this with your healthcare team.

 Recovery begins the day of surgery, so planning ahead is helpful.

Consider:

• Who will drive you home?

• Who can help during the first week?

• How will you obtain groceries?

• Who will care for pets?

• Do you need leave from work?

• When will physiotherapy begin?

Thinking through these questions beforehand allows you to focus on your recovery.

Feeling nervous before surgery is completely normal.  Many patients find it helpful to:

• Learn about the operation.

• Attend a pre-operative education session.

• Ask questions during consultations.

• Speak with family or friends.

• Focus on the goals they hope to achieve after surgery.

Understanding the recovery process often reduces anxiety.

Your hospital will provide a checklist, but this commonly includes:

• Comfortable clothing

• Supportive walking shoes

• Toiletries

• Glasses or hearing aids if required

• Medication list

• Walking aids (if requested)

Leave valuables at home whenever possible.

The evening before surgery:

✔ Follow fasting instructions provided by your hospital.

✔ Shower as instructed.

✔ Pack your hospital bag.

✔ Take medications only as advised.

✔ Get a good night's sleep if possible.

One of the biggest surprises for many patients is how soon rehabilitation begins.

Most patients:

• Stand on the day of surgery or the following morning.

• Begin walking with a physiotherapist.

• Start simple exercises immediately.

• Return home within two to four days.

Knowing this beforehand helps patients feel prepared and confident.

Should I lose weight before surgery?

If appropriate, even modest weight loss may improve your general health and reduce stress on the knee.  However, the decision should be individualised, and surgery should not necessarily be delayed if arthritis is severely affecting your quality of life.

Should I continue exercising?

Yes.  Continue exercising within your comfort limits.  Maintaining strength and mobility before surgery often makes rehabilitation easier afterwards.

Do I need physiotherapy before surgery?

Many patients benefit from a pre-operative physiotherapy programme, particularly if muscle weakness or reduced movement has developed because of arthritis.

Will I need help at home?

Most patients benefit from some assistance during the first one to two weeks, particularly with shopping, meal preparation and household tasks.

Is it normal to feel anxious?

Absolutely.  Feeling nervous before surgery is very common.  Learning about the operation and understanding the recovery process often helps patients feel more confident.

What does the Australian evidence tell us?

Evidence consistently shows that successful knee replacement depends on more than the operation itself.  Optimising medical conditions, maintaining strength, addressing modifiable risk factors and educating patients before surgery all contribute to safer surgery and a smoother recovery.  Australian registry data continues to demonstrate excellent long-term outcomes for knee replacement when evidence-based surgical techniques and appropriate implant selection are combined with comprehensive peri-operative care.

What does this mean for patients?

Preparing well before surgery gives you the best opportunity for a successful recovery.  While surgery relieves the arthritic pain, your strength, mobility and confidence are built through preparation and rehabilitation.

How does this influence my practice?

Preparation begins at your first consultation.  I work closely with your GP, physiotherapist and other healthcare professionals to optimise your health before surgery, discuss realistic expectations and ensure you feel informed at every stage.  My aim is not simply to perform a successful operation but to help you achieve the best possible long-term outcome.

Disclaimer: This article provides general information only and should not replace personalised advice from your orthopaedic surgeon, GP or physiotherapist.  Treatment recommendations should always be tailored to your individual circumstances.