Preop Preperation

If you are contemplating joint replacement it is important to be in your best possible condition before you have surgery. This will reduce your chances of complications during and after surgery, and will maximise your function and satisfaction post-surgery. Patients with good physical and mental preparation have shorter hospital stays, experience less pain and are overall more satisfied with their joint replacement. Below are some focus areas: 

Physiotherapy

• A 6 week combined clinic and home based pre-habilitation program is recommended. This leads to a shorter rehabilitation, better function and less pain.
• Focus areas should be
  – Muscle strengthening
  – Range of motion
  – Motivation/habit forming activity
• For more information on Physiotherapy click here

Exercise

• Muscle strengthening is important pre-surgery, as it allows for faster rehabilitation, better function and less pain.
• 180 minutes per week of low impact exercise is recommended prior to surgery.
• Patients with arthritic knees are advised to walk, cycle a stationary bike or use water based exercise, to the extent which their pain allows.

Diet (If your BMI is > 28)

• Almost all patients will be healthier on a lower carbohydrate diet. At the most basic level this consists of a 150 gram portion of beef chicken or fish with as much non-starch vegetable for your main meals. Good breakfast choices include foods such as eggs, avocado or oats. Nuts and fresh fruit are a good choice for snacks.
• Diet is important even in patients without diabetes. Recent research done by Orthopaedic Infection Specialist Dr Jarvid Parvivi has demonstrated high sugar levels are associated with higher rates of surgical infection.
• For more information on diet click here.

Anaemia

• Pre-operative screening for anaemia (low iron) and iron transfusion as necessary.
• The need for transfusion is uncommon if you start the operation with a normal red cell level.

Diabetes

• It is important to get your diabetic control within it’s best possible range before surgery.
• High sugar is equivalent to bacterial fertiliser and therefore increases the chance of infection, as well as impairing your body’s immune system.
• Ideal fasting sugars should be between 4-6, with a long term sugar (HbA1C) of less than 7.
• If you are struggling to reach these numbers, the dietary plan above is recommended, as is review by your GP.

Anxiety /  Depression

• Experiencing concern or worry leading up to your joint replacement is completely normal. The ACORN Registry, based in Sydney, shows that up to 60% of people have minor to moderate anxiety/depressive symptoms leading up to their joint replacement. This number improves dramatically following surgery.