Preparing for Surgery

How to prepare for knee replacement surgery

A video that depicts the pre-operative phase of the knee replacement surgery and what a patient can expect from this procedure.
 
Pre-operative Phase

This is the perfect time to make sure your body is in the best shape for surgery and a good time to prepare your home for your recovery.

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In the weeks leading up to surgery, your orthopaedic surgeon may:

  • Restrict and supplement your diet.
  • Ask you to stop taking certain medications.
  • Refer you to a physical therapist and recommend if pre-surgical exercises are right for you. After all, a stronger leg going into surgery is also a stronger leg coming out of surgery and can help make your recovery faster and easier.

You and your caregiver should take this time to familiarize yourselves with the surgery and what to expect during your hospital stay. You should also find out what to bring to the hospital to make your time there more comfortable. And learn what you can do to prepare your home for your rehabilitation.

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Planning for your knee replacement surgery

 
 

Getting in shape for surgery

 
 

A typical pre-surgery exercise routine

Exercising daily can help you prepare your body for knee replacement surgery. The muscles of the thigh and leg contribute to the stability of the knee joint. Consult with your doctor and physical therapist before beginning any surgical preparation.

Forward lunge exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Stand with your feet hip length apart. Step forward with the leg of the affected knee until it bends at a 90 degree angle (if you can’t bend that far, it’s okay). Your weight should be on your heels. Your injured knee should not bend past your toes. Return to the starting position. Repeat 10 times twice a day.

Horizontal heel slides exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Lie down with both legs straight out in front of you. Slowly bend the affected knee while sliding your heel along the ground towards you. Hold this stretch for five seconds. Then, straighten the leg again, sliding the heel along the whole time. You can decide to adjust the intensity of this exercise on your own as long as you’re not feeling too much pain after the stretch. Repeat 10 times.

Quad sets exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Lie down with both legs straight out in front of you. Gently tense the muscle in back of your thigh of the leg with the affected knee, pushing the back of your knee down to touch the ground. Hold for five seconds and release. Repeat 10 times. For a stronger stretch, flex your foot back as you tighten your thigh muscle.

Quad stretch in prone position exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Lie facing down on a flat surface. Attach a stretching cord or towel to the ankle of the affected leg. Grab the other side of the cord or towel with the hand on the same side of your body as the affected leg and pull your leg towards your buttock until a stretch is felt in the front of the thigh. Hold for 10 seconds and relax. Repeat 10 times.

Seated hamstring stretch exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Sit on the edge of a bed or couch. Stretch the leg with the affected knee out on the surface of the bed or couch, and place the other foot on the floor. Your injured knee should be as straight as possible. Keeping your back straight, lean forward into the extended leg with your arms stretched towards your toes. Hold for 10 seconds and then relax. Repeat 10 times.

Seated knee extensions exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

From a seated position with both knees bent, tighten the quad or thigh muscle on the leg of your affected knee. Raise the foot off the floor until your affected knee is straight. (A full extension may not be possible.) Hold for three to five seconds. Then, return your foot to the floor. Relax the quad muscle. Repeat 30 times twice a day.

Short arc quad extension exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Lie down with both legs lying flat and straight. Place a rolled up towel or small pillow at least 6 inches in diameter under the affected knee. Tighten your thigh muscle as you extend your lower leg by lifting your heel off the ground. Be sure not to lift your knee. Try to extend your knee as much as possible and perform slow and controlled movements. (A full extension may not be possible.) Hold for five seconds and release. Repeat 10 times.

Side-lying hip abductions exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Lie on your side with the leg of your good knee on the ground. Both legs should be straight. For stability, place the palm of the hand on the side of your body with the affected knee firmly on the ground in front of you. Slowly raise the leg of the affected knee eight to 10 inches from the ground without bending the knee. Lead upwards with the side of your foot. Hold for five seconds and slowly lower it until it rests on your other leg again. Repeat 20 times twice a day.

Step-ups exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Stand on a stair or step stool. Squeeze the thigh and hip muscles of the injured leg. Slowly bend this leg and lower the leg with the good knee to the ground while keeping the hips level. Return the leg to the stair or step stool. Repeat 10 times twice a day. Note: Most steps are six to eight inches high. If possible, when first performing this exercise at a low intensity level, the step should be only four inches high. Once this becomes too easy, you can progress to a six to eight inch high step.

Straight leg raises exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Lie down with the leg of the affected knee lying flat and straight, and the other knee bent with the foot firmly on the ground. Tighten the quad, or thigh muscle, of the straight leg and lift it off the ground, keeping the affected knee as straight as possible. Do not lift your leg any higher than the bent knee on the other leg. Lower your leg back down to the ground. Repeat 20 times twice a day.

Walking exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Walking is one of the most important exercises you can do to prepare for knee replacement surgery. Find a location where you can walk for an extended period of time without having to stop, such as a park, the track in a gym or a shopping mall. Walk for the prescribed time, maintaining a steady pace (most city blocks are around 400 feet long). If you are unable to tolerate walking, light bicycle riding— especially on a stationary bike— is a good option, if you can bend your knee 110– 120 degrees. Start by walking 1,500 feet (about four city blocks) a day.

Wall squats exercise demonstration video used to assist as a part of a pre-knee replacement surgery exercise routine.
 

Stand with your feet hip length apart about six inches from a wall. Lean against the wall so your back lies flat. Your weight should be on your heels. Slowly lower your buttocks toward the floor until you’re in a 90-degree seated position, if possible. If you can’t reach 90 degrees, that’s okay. Slowly raise the buttocks until you’re standing again. Repeat 10 times twice a day.

References
  • Surgery: Norton, Barrie & Bollinger, page 323 Barrie.
  • American Academy of Orthopaedic Surgeons (AAOS) 2011 Annual Meeting. Abstract 473. Presented February 17, 2011. Source: http://www.medscape.com/viewarticle/737679 . Site reviewed 2/22/11.

IMPORTANT SAFETY INFORMATION

The performance of knee replacements depends on age, weight, activity level and other factors. There are potential risks and recovery takes time. People with conditions limiting rehabilitation should not have this surgery. Only an orthopaedic surgeon can tell if knee replacement is right for you.

DSUS/JRC/1016/1839 11/2016

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