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Orthopaedic joint replacements (hip and knee)

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It is never too early to prepare for your operation once you have been listed for a hip or knee replacement. This may be called prehabilitation (prehab) or waiting well.

By reading and following the advice of the information below you can reduce your pain while waiting for the operation and improve your outcomes long into your recovery.

Waiting well

Taking ownership of your health and wellbeing can improve recovery and this can be achieved by healthy diet, exercising, smoking cessation, home preparation and support with finances.

Healthy diet

Eating well and supplementing your diet with vitamins can be an important step to ensure that your body is well nourished to prepare it for an operation and to support the healing process. Eating well will reduce your chance of infection, inflammation and reduce the risk of complications.

Required weight loss will also reduce the strain on mobility, easing pain prior to the operation and improving outcomes afterwards.

It is important to drink plenty of water and eat a wide variety of food that includes:

  • plenty of fruit and vegetables
  • plenty of wholegrain bread, cereals, pasta, potatoes and rice
  • beans, lentils and other pulses
  • fish, especially oily fish
  • some milk and dairy foods
  • meat, eggs, chicken and nuts

Some foods are of lower nutritional value: sweet and sugary drinks, cakes, biscuits, sweets, chocolate, crisps and takeaway meals. Eating low nutritional value meals or eating too little will reduce your energy levels and not allow you to exercise as well as you are able, which will impact your pain levels before and after your operation and hinder your recovery afterwards.

See more information on healthy eating at the British Dietetic Association

Exercises

Exercising is an important part of joint replacement. It is never too early to start a regime of regular exercising and recommended exercises can be extended long into your recovery. These will reduce your pain and allow you to return to normal function at a faster rate.

A regime of exercises can be found in the arthroplasty booklet that you will receive at your pre-op assessment appointment. Exercises can also be found on the Versus Arthritis site:

Highlife Highland also offer suitable classes that can be used before and after the operation:

  • Active Health Dynamic Wellbeing - for exercise assistance and optimisation without focusing on medical disabilities but instead focusing on the general wellbeing of the participant
  • Escape Pain offers arthritis-specific exercise management for both hip and knee pain

Both of these classes are free to leisure cardholders and can be booked online or by contacting participating leisure centres.

Think Health Think Nature will highlight local facilities that will enable you to begin making small changes that lead to a positive change in your health and promote your health while on the waiting list and into recovery.

MySelf-Management promotes and empowers those living with long-term conditions to take responsibility for their health and wellbeing. It is never too late or early to participate in my self management. This can be used long before you are placed on the waiting list and may be beneficial to those that are just beginning to experience pain in their hip or knee.

Smoking cessation

If you are a smoker your general health is at risk. Smoking also causes some additional risks and complications for your surgery such as:

  • increased risk from having an anaesthetic, in particular, developing a chest infection or pneumonia
  • increased time for your wound to heal
  • increased risk of getting an infection
  • increased risk of developing a blood clot after your operation, known as a deep venous thrombosis or pulmonary embolism

As a minimum, stop smoking for at least four weeks before and after your joint replacement surgery.

See Smoke Free Highland for further information, including contact details.

Home preparation

In some cases it is possible to get home the same day as your operation, but most are home within 1-2 days of their operation. As such, your home should be prepared prior to your operation. You may need to change the way you carry out some everyday tasks and there are a few simple things you can do which will make life easier for when you get home:

  • Throughout your home, and particularly your kitchen, put things that you use regularly at a height where you don’t have to bend or stretch too much to reach.
  • Remove any loose rugs or anything else you might trip or slip on. Keep extension cords or cables well away from where you will be walking.
  • When you get home you will need walking aids. Remove anything which will get in your way of moving easily from room to room. You may wish to consider getting a small back pack to carry things. A flask can also be useful for carrying drinks.
  • Think about how you will manage to wash yourself after your operation: if you have a shower over your bath you may need to do a strip wash for the first few weeks. It is not recommended that you sit in a bath until you are able to safely do this (usually around 4-6 weeks).
  • If you are struggling with dressing (particularly putting on socks and shoes) you may wish to purchase small dressing aids such as a long shoe horn, grabber and/or sock aid to help with this. These are available online or in some chemists.
  • Have good lighting and easy access to a night light.
  • Have a stool accessible to elevate your legs (knees only).
  • Make you have a stock of food in the house and other things that you will need on a daily basis. Have food that is quick and easy to prepare.
  • Please complete this form (alternative formats are provided) and return it by email or post:

Finances

If you experience any financial difficulties while waiting for or recovery for your operation, NHS Highland has developed an app to provide financial support for anyone with money worries.

Important: Waiting well at NHS inform

NHS Inform Logo

The following link may help if you are accessing this service from another health board.

You may be put on a waiting list to see a healthcare specialist or to get health and social care services. This page has information to support your health and wellbeing, including information on your physical and mental health, as well as advice about practical issues like money worries:

Waiting well at NHS inform

Arthroplasty booklet

At your pre-operative assessment you will receive this arthroplasty booklet.

This is an important tool to help make your recovery easier, and will make you aware of what to expect before and after your operation. It is essential to read this prior to your operation and to commence the exercises found in the booklet at the earliest opportunity.

Enhancing Your Recovery After Joint Replacement Surgery (cover)

Arthroplasty prehab presentation

Prior to your operation you are invited to attend a brief arthroplasty prehab presentation. This takes place over Near Me every Wednesday at 2pm to prepare you for your joint replacement. We recommend attending on the nearest Wednesday before your operation.

The presentation includes information on:

  • what to expect during your stay when you receive a joint replacement
  • how to prepare your home for discharge
  • how to maximise your recovery, including wound care and exercise
  • what to do if there are any issues after your operation

At the end of the presentation there is a question and answer session that may help to relieve any anxieties that you feel prior to your operation.

Accessing Near Me

You can access this class by using your mobile, tablet or computer. The waiting room will open at 1.45pm for the course to begin at 2pm. Use this link (or enter it into your browser):

https://nhsattend.vc/AJS-NHSH

You'll need an Internet-connected device. Camera and microphone are optional.

Unable to attend

If you're unable to attend the arthroplasty prehab presentation, you can view the video recording below.

Contact

If you have any questions on the arthroplasty prehab, please contact the ERAS Practitioner:

National Treatment Centre - Highland

You may have your joint replacement operation at the National Treatment Centre - Highland (NTC-H). In some cases you may be coming from a health board other than NHS Highland, in which case some of these links and courses may not be applicable.

If you have any general enquiries related to your admission to the NTC-H, please use the contact details here.

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Last updated: 16 April 2024

Next review date: 20 September 2024