Before Total Knee Replacement Surgery

Before Total Knee Replacement Surgery

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  • Before Total Knee Replacement Surgery

    Before Total Knee Replacement Surgery

    Having a total knee replacement (TKR) is a far cry from your typical doctor’s visit. It’s a serious undertaking that will have a complex impact on your life—both immediately following the surgery and for years to come. It’s essential to take your time beforehand and go through the process step by step. In doing so, you’ll help ensure the best outcome from your surgery.

    Click “next” to learn about whatyou should do to prepare for your surgery.

  • Pre-Operative Evaluation

    Pre-Operative Evaluation

    After you’ve made the decision to move forward with a knee replacement, you’ll undergo a pre-operative evaluation and testing. Your medical team will determine whether you’re a suitable candidate for surgery and identify any potential complications. This will help ensure a successful operation. 

  • Pre-Admission Testing

    Pre-Admission Testing

    About one to two weeks before your procedure, you’ll likely undergo pre-admission testing, referred to as “PAT.” This includes a physical exam, a detailed questionnaire, a complete blood count—which checks for everything from diabetes to anemia, a coagulation test to determine whether your blood will clot normally, and a baseline metabolic analysis of your kidneys, liver, and pancreas. You may also have an EKG to verify the health of your heart.

  • Scheduling Surgery

    Scheduling Surgery

    Typically, your surgeon’s office will schedule the surgery four to six weeks from the time you have consented to the procedure. The wait is a good thing. During this time, there are many steps and preparations you’ll be taking care of—all of which are explained in the next few slides.

  • Medication Adjustments

    Medication Adjustments

    If you’re currently taking any prescription medications, your doctor may want to adjust your prescription. They may also prescribe new drugs, such as blood thinners, to make the surgery proceed more smoothly. As one major side effect of surgery is infection—particularly for patients with weakened immune systems—you’ll also likely take antibiotics to shore up your immune system. 

  • Imaging


    Your doctor will request X-rays and possibly an MRI to fully understand the condition of your knee. These images will enable your doctor toactually see your knee, and will help them make the right decision about the sizing and placement of your implant. The images will also help to determine the best surgical approach. 

  • Anesthesiologist Consult

    Anesthesiologist Consult

    During the surgery, you’ll be placed under anesthesia—meaning, you’ll be administered a drug that will cause you to feel no physical pain. Prior to the surgery, an anesthesiologist (anesthesia expert) will review your health history and conduct pre-admission testing to determine what anesthetic is best for you.

  • Banking Blood

    Banking Blood

    “Banking blood” means having blood drawn and saved prior to the surgery, so that it’s available to use if a transfusion is needed during the operation. About 20 percent of TKR patients require a transfusion, according to the Cleveland Clinic. If you can’t or choose not to bank your own blood prior to surgery and you require a transfusion during surgery, you will receive screened blood from a blood bank that matches your blood type. 

  • Classroom Preparation

    Classroom Preparation

    Your surgeon might also request that you attend a class that thoroughly explains the procedure and helps you understand what will take place at every phase of the knee replacement process. Nurses typically teach these classes, and they may be hosted at the hospital. You might also receive a DVD that explains all the steps from admission to discharge.

  • Muscle Strengthening

    Muscle Strengthening

    Before the surgery, your doctor or physical therapist may ask you to participate in a muscle-strengthening program. Studies indicate that patients who start physical therapy and strengthen their muscles before surgery achieve a faster and better recovery. The added muscle helps your body adapt to the implant and withstand rehabilitation better. 

  • Pre-Surgery Exercises

    Pre-Surgery Exercises

    Exercises that you do before surgery will aid in your rehabilitation by making your body stronger and able to heal better. Exercises you may want to try include: ankle pumps and circles, thigh squeezes, heel slides, leg slides, lying kicks, straight leg raises, knee bends, sitting kicks, and chair push-ups.

    For diagrams of various exercises, click here.

  • Mental Preparation

    Mental Preparation

    As with any surgery, recovery is never easy. Expect some pain and discomfort—along with frustration over your limited ability to move around. It may help to read about experiences from other TKR patients to get a good sense what to expect. When things do get challenging—and they will, focus on the rewards of once again being able to engage in your favorite activities. With the right preparation, you can increase the odds for a faster and smoother recovery.