Pre-admission assessment
Before surgery you will be seen for a pre-admission assessment at the hospital. This checks that you are fit for the anaesthetic and the operation, and it is where practical arrangements are sorted out. It usually covers:
- Your general health, and any heart, lung, kidney or diabetes issues
- All your medications, including anything bought over the counter and any supplements
- Blood tests, and sometimes an ECG or other tests depending on your health
- A discussion with an anaesthetist about the type of anaesthetic
- Screening for bacteria that could cause a wound infection
- Planning for how you will manage at home afterwards
Medications
Some medications need to be stopped or adjusted before surgery, and some must be continued. This particularly applies to blood thinners and anti-platelet medication, diabetes medication including insulin, and some medications used for inflammatory arthritis.
What you can do beforehand
Going into an operation in the best condition you can manage is worth real effort.
These are the things within your control:
- Stop smoking If you smoke. Smoking affects wound healing, bone healing and infection risk. Your GP, Quitline or a pharmacist can help.
- Keep moving Maintaining strength and fitness before surgery makes the recovery afterwards easier. A physiotherapist can give you a programme that works around the painful joint.
- Manage your weight Where that is relevant to you. Eat well too, because protein and vitamin D matter for healing.
- Control your diabetes If you have diabetes, get your control as good as it can be. Blood sugar control affects infection risk directly.
- See your dentist If you have any dental problems, get them dealt with before rather than after joint replacement surgery.
- Deal with skin problems Cuts, ulcers, infected ingrown toenails or rashes near the operation site. Tell the team if any appear before surgery.
Getting home ready
Practical preparation makes the first fortnight much easier.
Around the house
- Move things you use daily to bench and waist height so you are not bending or reaching
- Remove loose rugs and trailing cords, and make sure hallways are clear and well lit
- Set up a firm chair with arms that you can get out of easily
- Sort out grab rails, a raised toilet seat or a shower stool if these have been suggested
People and logistics
- Arrange someone to drive you home and, ideally, stay with you for the first few days
- Cook and freeze some meals in advance
- Organise help with pets, children, shopping and anything that involves lifting
- Plan how you will get to follow-up appointments and physiotherapy
The day of surgery
You will be given fasting instructions, meaning how long before surgery to stop eating and drinking, and an arrival time. Follow them exactly, because surgery is postponed if fasting instructions have not been met. Leave jewellery and valuables at home, and bring your regular medications in their original packaging.