Total Joint Replacement 101: Surgery Timeline

Hip replacement surgery and knee replacement surgery can help relieve your pain and enable you to live a more active life. If you and your orthopedic surgeon have decided that you are a good candidate for joint replacement surgery, there are some necessary steps to complete in order to prepare for your surgery.


After you are discharged from the hospital, your coach should be prepared to support your recovery, particularly during the week after surgery. It is important that your coach comes with you to all of your appointments and has a good understanding of what you will need after surgery.

Do NOT plan on going to a skilled nursing facility or transitional care for your recovery. In order for insurance to authorize a stay in these facilities, it must be a medical necessity. Not having support care at home is NOT considered a medical necessity. In addition, there are often no beds available in these facilities.

One month before surgery…

  • We recommend that you visit your dentist at least one month before your surgery to ensure that you don’t have any infections or other problems that could complicate your surgery. Have all dental work completed – including a routine cleaning – at least a month prior to allow sufficient time for healing and to minimize your risk of infection.
  • Within four weeks of your surgery date, you will need to complete all necessary lab work and an EKG, to check your heart health. This may be done with your primary care provider or separately.
  • The surgery scheduling staff at The Center will help arrange an appointment with your primary care provider for a presurgical physical prior to surgery. Your provider will evaluate your overall health and determine if you should proceed with surgery. Often, you can have your lab work and EKG done at this time.
  • Attend a total joint education class at St. Charles Medical Center. This important class explains what to expect in the hospital and what you’ll need for your recovery at home.

One week before surgery…

  • Stop taking all anti-inflammatory medications for seven days before surgery. These may include prescribed NSAIDS (mobic, celebrex, voltaren, etc.)  or over-the-counter medications (ibuprofen, Advil, Aleve, naproxen, etc.).
  • Stop taking all vitamins and herbal supplements for seven days prior to surgery. These supplements can interfere with the anesthesia and some can thin your blood.
  • If you are on blood thinners i.e. aspirin, Coumadin (warfarin), Plavix (clopidogrel), Lovenex (enoxaparin), Pradaxa, Effient (prasugrel), Brilinata (Ticagrelor), Aggrenox (aspirin, extended release dipyridamole), Xarelto (rivaroxaban), or Eliquis (apixaban), then your primary care provider will direct you when to stop these medications prior to your surgery. It is important that these medications are stopped under the direction of your primary care provider.
  • Approximately one week before your surgery, you will meet with your surgeon and his or her nurse practitioner (NP) or physician assistant (PA). At this appointment, we will review teh following:
    • Information gathered from your primary care provider
    • Surgical site
    • Education about your upcoming surgery
    • Home recovery plans
    • Therapy and equipment
    • Benefits, risks, and alternatives to your upcoming surgery.
  • Make sure your home is ready for recovery to help minimize issues later.

The night before surgery…

  • Do not eat or drink anything after midnight, unless instructed otherwise by your pre-surgery nurse.
  • Limit your alcohol and tobacco product consumption for 48 hours before surgery.
  • Take any medications as instructed to do so by the pre-surgery nurse.
  • Make sure your hospital bag is packed and ready. Be sure to wear comfortable clothes to and from your surgery. Bring glasses, contacts, hearing aids, and denture containers. Leave your valuables at home.
  • Set your alarm and be sure to get a good night’s rest.