Eytan DebbiHip & Knee Replacement
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Patient Resources  ›  Before Surgery
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Preparing for your surgery

The weeks and days leading up to your hip or knee replacement, medical clearance, medications, home setup, and what to pack.

Medical clearance

Within about 30 days of your surgery date, you will need a pre-operative medical evaluation. This typically includes lab work, an EKG, and a physical exam performed by your primary care physician or an internist.

If you have specific conditions, heart disease, diabetes, lung disease, a history of blood clots, your team may ask for additional evaluations from the relevant specialist. Bring the results of these evaluations with you or have your physician's office send them to the surgical office in advance.

Bring to every appointment A complete list of your current medications and supplements (including doses), your insurance cards, a photo ID, and any recent imaging (X-rays, MRI, CT) on disc if it was done outside HSS.

Medications

You will receive a specific medication list from the office. Some medications must be stopped before surgery; others should be continued right up until the morning of. Do not stop any medication without confirming with your prescribing physician and our office.

Typically stopped before surgery

  • Blood thinners and anti-platelets (aspirin, Plavix, warfarin, Eliquis, Xarelto), timing varies by medication; your team will provide exact dates.
  • Anti-inflammatories (ibuprofen, Motrin, Advil, Aleve, Celebrex, Mobic), usually stopped 7 days before surgery.
  • Herbal supplements and vitamins (fish oil, vitamin E, garlic, ginkgo, ginseng), stopped 7 days before.
  • Certain diabetes and biologic medications, your team will give a specific schedule.

Typically continued

  • Tylenol (acetaminophen) is generally fine for pain.
  • Blood pressure, thyroid, and most cardiac medications are usually taken the morning of surgery with a small sip of water, confirm with the office.

Dental work

Any necessary dental work, cleanings, fillings, extractions, should be completed before your surgery. Infection in the mouth can travel through the bloodstream and reach a new joint implant. After surgery, wait at least three months before elective dental work, and longer for any procedure involving bleeding.

Skin preparation

Healthy skin is one of the most important defenses against infection. In the days before surgery:

  • Inspect the skin over and around the surgical site. If you notice any cuts, scrapes, rashes, blisters, insect bites, or breaks in the skin, notify the office, surgery may need to be rescheduled until the skin is fully healed.
  • Do not shave the surgical leg for at least 5 days before surgery. The surgical team will clip any hair at the time of surgery.
  • You will be given a chlorhexidine (CHG) skin wash protocol, typically the night before and morning of surgery. Follow the instructions exactly.
  • Do not apply lotion, cream, powder, or perfume to your body the morning of surgery.
  • Remove nail polish, acrylic nails, and all jewelry before coming in.

Preparing your home

Small changes to your home make the first few weeks of recovery significantly easier and safer.

  • Remove throw rugs and clear pathways between the bedroom, bathroom, and kitchen.
  • Tape down or tuck away electrical cords.
  • Arrange for a firm chair with armrests and a seat height that lets you stand up easily.
  • Move frequently-used items (dishes, clothing, toiletries) to waist height so you do not need to bend or reach.
  • Install a raised toilet seat and grab bars in the bathroom if recommended. A shower chair and a handheld showerhead are helpful.
  • Stock up on easy-to-prepare meals, or prepare and freeze meals in advance.
  • Arrange for someone to be at home with you for at least the first several days after you are discharged.
  • If you live in a walk-up, plan how you will get up the stairs on the day of discharge.

What to pack

Pack a small bag the day before. Keep it light, you will be up and walking quickly.

  • Insurance cards, photo ID, and a copy of your advance directive if you have one.
  • Loose-fitting clothing to wear home, shorts or pants with an elastic waistband, a loose t-shirt, and slip-on shoes with a closed back (no flip-flops or backless slippers).
  • Toiletries: toothbrush, toothpaste, comb, deodorant, glasses (leave contacts at home).
  • CPAP machine mask, tubing, and a copy of the settings if you use one, do not bring the machine itself.
  • A phone charger with a long cord.
  • A list of your medications and the phone numbers of your emergency contacts.
  • Leave valuables, cash, and jewelry at home.

The night before & morning of

  • Do not eat or drink anything after midnight the night before surgery unless specifically told otherwise, this includes water, gum, mints, and candy.
  • Complete the CHG skin wash as instructed.
  • Get a full night's sleep if you can.
  • The morning of surgery, shower with the CHG wash again. Do not apply lotion, deodorant, makeup, or perfume.
  • Take only the medications you were told to take, with a very small sip of water.
  • Dress in loose, comfortable clothing and leave home in plenty of time to arrive at your scheduled check-in.
Summarized from HSS: Things to do before your surgeryHSS: Knee Replacementand HSS: Hip Replacement patient education. This guide is general, always follow the specific instructions from Dr. Debbi and your care team.