Why the weeks before surgery matter
Joint replacement surgery is almost always planned well in advance, and that lead time is useful. The weeks before an operation are an opportunity to get into the best condition reasonably achievable, and the steps taken during that period can influence both the early recovery and the longer-term function of the joint.
Dr Kenneth Cutbush has recorded a discussion of practical advice on preparing for joint replacement surgery, covering the preoperative steps that can make a difference to recovery. It is intended to be useful to patients, and also to the physiotherapists, surgeons and allied health professionals involved along the way.
Managing expectations
Much of preparation is simply understanding what the operation is intended to achieve and over what timeframe. Joint replacement is generally aimed at reducing pain and improving function rather than returning a joint to the state it was in before the problem began. Recovery is also gradual: improvement is usually measured over months rather than weeks, and there is a period early on when the joint feels worse before it feels better.
Knowing this in advance tends to make the recovery easier to work through. It is worth asking, before the day of surgery, what range of movement and what level of activity are realistic in your particular case. Our surgery FAQs cover many of the questions that commonly come up.
Addressing modifiable risk factors
Some of the things that affect how an operation and recovery go can be improved beforehand. These are generally discussed at the pre-operative consultation and may include:
- Smoking. Stopping, or at least reducing, before surgery is widely recommended because smoking affects wound and soft-tissue healing.
- Blood glucose control. For people with diabetes, having glucose levels as well controlled as possible before surgery is a standard recommendation.
- Anaemia. Low iron or haemoglobin is often checked and corrected before a planned joint replacement.
- Skin condition. Any breaks, rashes or infections in the skin near the operative site should be reported, as they may be a reason to postpone.
- Dental and other sources of infection. Outstanding dental work is usually better dealt with before a joint replacement than shortly after it.
- General conditioning. Maintaining movement and strength in the limb and the surrounding muscles beforehand gives rehabilitation a better starting point.
Which of these apply, and what to do about them, depends on your own health and should be worked out with your surgeon and general practitioner rather than assumed from a general list.
Practical preparation at home
It helps to sort out the practical side before the day rather than after it. That usually means arranging transport home and someone to help for the first stretch, thinking about how you will manage showering and dressing with a limb that is restricted, moving frequently used items to a height you can reach easily, preparing some meals in advance, and confirming which of your regular medications should be stopped and when.
Watch the discussion
The full discussion is available via this link: watch the video. You can also follow Dr Cutbush on TikTok (@KennethCutbush), YouTube (@DrKennethCutbush), Instagram (@DrKennethCutbush) and Facebook (@KennethCutbush).
Next steps
If you are weighing up whether to proceed with a shoulder replacement, it is reasonable to start by understanding the condition being treated and the alternatives. Our pages on shoulder arthritis, anatomic total shoulder replacement and reverse total shoulder replacement explain the options, and the rehabilitation page sets out what happens afterwards. To arrange an assessment, see the consultation page.