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September 07 2019 at 01:11 PM by Dr. Smarajit Patnaik


Dr Smarajit Patnaik 
Senior Consultant Orthopaedic & Joint replacement surgeon 
Apollo Hospitals, Bhubaneswar 
Simpleekare health Pvt Ltd 
N2/19, Nayapalli, Bhubaneswar 

Knee replacement surgery is a crowning achievement in modern medicine, delivering unmatched relief to patients in need while yielding impressively high success rates.

Did you know that the overall success and recovery time of your knee replacement is largely determined by what you do the weeks before your surgery?

6 Must-Do’s To Prepare For Your Knee Replacement

1. The Support of Family, Friends and Peers

 The support of family and friends is “one of the most important factors” in determining the overall success and recovery time of a knee replacement. Not only will the support of family and friends be of great help post-surgery, but it will also actually help with physical and mental preparedness in the weeks prior.
Speaking with those who are a few months ahead of you in the knee replacement surgery and recovery cycle personalizes the procedure, offering a greater level of insight and alleviate anxiety.
Why the Support of Others Matters:
 • If you’re committed to setting goals like eating a nutritionally-rich diet or keeping up with daily exercises in order to reduce your risk and improve your outcome, the support of family, friends and peers is key for accountability.
 • You’re more likely to remain motivated and focused when you have the support of a group.
 • Connecting with knee replacement recipients will encourage you to follow suit.

2. Improve Your Diet

We’ve all heard the saying “you are what you eat” and this can’t be better illustrated than when we’re talking about surgery. If you’re eating foods that are boosting your health before surgery than you’ll be a supercharged healer after surgery. Specifically, eating foods that are rich in protein, fibre, calcium and vitamin C and D, provide your body with the building blocks to promote faster healing after your joint replacement.
What You Should Eat and Why:
 • Calcium and Vitamin D—Calcium is an important part of strong bones and the healing of your bones after surgery. Vitamin D helps your body absorb calcium. 
 • Iron and Vitamin C—Having a diet rich in iron and vitamin C will help boost pre-operative red blood cell levels and may reduce postoperative anaemia or the need for a blood transfusion.
 • Protein—Protein is essential for an incision to repair itself and boosts overall healing. 
 • Fibre—Fiber helps to control blood sugar (which if uncontrolled can increase wound infection, blood clots and lead to the need for revision surgery) and works to counteract the constipating effect of the painkillers prescribed post-surgery. 

3. Exercise the Muscles Around the Knee

In the weeks leading up to surgery, targeted exercises to build up strength in the muscles surrounding your knee is quite impactful. The stronger and more flexible your surrounding muscles are, the easier it will be to resume your favourite activities after the replacement. In addition to helping you bounce back, these purposeful, low-impact exercises will reduce fatigue, muscle soreness, swelling and the risk of blood clots.
Before surgery, exercises should primarily target your hamstrings and quadriceps.
Simple Exercises with Impact
Quad Sets
 0. Lie on your back in bed with your legs straight.
 0. Tighten your thigh muscle by pushing your knee down into the bed. Sometimes placing a small towel under your ankle facilitates this.
10 reps, 2x per day
Sitting Knee Flexion
 0. Sit on a chair with a towel under your surgical leg(s). Your feet should be flat on the floor.
 0. Slide one foot back, bending your surgical knee.
 0. Hold for 5 seconds, the slide your foot forward.
10 reps, 2x per day
Side Leg Raises
 0. Lie on your side in bed with your legs straight.
 0. Keep your knee straight and lift the “up” leg 2-3 inches.
 0. Hold for 5 seconds and then lower the leg in a controlled manner.
10 reps, 2x per day

4. Develop a Pain Plan and Practice Mindfulness

Naturally, one of the most pressing concerns and drivers of anxiety before surgery is the amount of pain that will be endured. No one wants to be in more pain than absolutely necessary and uncontrolled amounts of pain actually slows down the healing process. Learning about pain management, developing a “pain plan”, and practising mindfulness before surgery puts your mind at ease and places you back in control.
Important Pain Management To-Do’s:
Understand Your Pain Medications
Many patients require medications to minimize pain prior to surgery. These medications come in many varieties and are classified as 1. Acetaminophen-based 2. Anti-inflammatory based NSAIDs and 3. Narcotic-based.
Anti-inflammatory based medications should be stopped about a week prior to surgery while acetaminophen-based medications can be taken through to surgery day. 

Saying Yes or No to a Nerve Block
A nerve block (also known as a local anaesthetic) is a medical procedure that is changing the face of knee replacement surgery. Nerve blocks make it possible for patients to avoid general anaesthesia which is riskier and increases surgery recovery time. Evidence shows that patients who go for general anaesthetic in exchange for a nerve block require fewer narcotic painkillers after surgery, have a reduced hospital stay and lower rates of blood clots.
Nerve blocks are becoming an increasingly popular choice for knee replacement patients and are an option you should discuss with your doctor and surgeon in your pre-op visit.
Practice Mindfulness
Mindfulness is a simple concept but when exercised effectively, can be used to manage pain, reduce the need for painkillers, and help alleviate feelings of anxiety, depression, frustration and stress.
To put it simply, mindfulness is paying attention to the present moment on purpose and with fresh eyes. “Mental preparedness is absolutely everything. Patients that go into surgery with positive thinking actually do better.”
Mindfulness helps put negative and anxious feelings about surgery at bay.

5. Better Your Odds for Success by Controlling What You Can

Beyond exercising and boosting your body with nutrition that promotes healing, it’s important to go the extra mile to be in the best health possible.
How to Be in Your Best Health
 • Quit Smoking—For smokers, quitting smoking is the single most impactful thing you can do improve your safety and recovery. Smoking is associated with complications like wound infections, pneumonia, stroke and death. 
 • Lose Extra Weight—For those overweight, shedding some extra weight before surgery drastically cuts down your risk and improves recovery time.
 • Manage Blood Sugar—Perform extra due-diligence when managing stress levels and blood sugar before surgery. It’s essential for diabetics to form a meal and medication plan for the week leading up to surgery.
 • Avoid Dental Work—Dental work, including cleaning, can release bacteria into your bloodstream. This bacteria can increase your chances of infection. It’s best to avoid elective dental work in the weeks before surgery.

6. Be as Prepared as Possible

Your mobility will be greatly reduced in the days following a knee replacement it’s crucial to plan ahead.
Ways to get prepared:
 • Pre-order and Test Walking Devices—Make sure you’ve ordered mobility equipment to arrive on time for surgery day. While getting adjusted to a walker, crutch or cane is fairly simple, having a test run is ideal.
 • Pack an Overnight Bag—Pack everything you may need for your hospital stay including important documents for insurance and bank documents.
 • Prepare Your Home—Prepare your home by removing obstacles like cords or furniture that may get in your way, creating a downstairs living space and installing an elevated toilet seat.

Knee replacement surgery is quite literally a step toward your new life. Now, more than ever, you have the power to control the outcome of this powerful surgery through the actions you take in the weeks leading up to it.

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