Good overall health is a precondition

Joint replacement surgery requires a lot of preparations. After your overall health has been checked and you are given a surgical clearance, your doctor will refer you to the surgical outpatient clinic at the Central Finland Central Hospital. For a surgical clearance, the following things need to be taken care of.

1. Make sure your long-time diseases are under control

Long-time diseases should be under control, as that makes the surgery and recovery process easier for you. Your health centre will refer you to a nurse and a physiotherapist who will then check your current health, and if needed, schedule further examinations.

Examples on the importance of controlled long-time diseases:

Asthma and COPD. Controlled health of your lungs enhances the safety of the operation by minimizing risks and making the recovery process smoother.

  • If needed, your nurse will refer you further examinations such as a pulmonary function test.

Diabetes. When your diabetes is under control, the wounds will heal quicker and the chance of infection is lower.

  • Make sure to control your blood sugar. If the levels differ from your target range, contact the health centre in charge of your diabetic care.

Prostate enlargement

  • Before surgery, men with prostate enlargement need to take care of any possible difficulties with urinating. Discuss the matter with your doctor.

Skin conditions and ulcers. Acute skin infections and infected rashes prevent the surgery, as bacteria on your skin may spread to the joint replacement via circulation and cause infections.

  • Make sure your skin is as intact as possible before the operation. If your skin condition gets worse near the surgery, contact your health centre.

Rheumatoid arthritis. Your doctor will advise you to stop taking biologic drugs before the operation. This decreases the risk of infections.

  • Make sure your arthritis is under control. If you have any problems with your condition, contact the provider of your rheumatic care.

Hypertension and coronary artery disease. Controlled situation enhances the safety of your operation as well as the recovery process.

2. Check your skin condition

Scratches, scabs, pimples, infected rashes, paronychia, leg ulcers as well as intertrigo or ulcers between your toes will prevent your surgery.

To take care of your feet at home, wash and dry them thoroughly, and wear well-fitting cotton socks that are non-binding. Contact a nurse or a foot therapist if you notice any skin or nail deformities you cannot take care of yourself.

Before surgery:

Check and take care of all possible skin infections such as intertrigo or ulcers between your toes, under your breasts, and in the inguinal region.

Avoid scratching and rubbing your skin

Avoid shaving during the last 7 days before your surgery.

3. Dental care

Make an appointment with a dentist. Your doctor will give you more instructions. All problems with your mouth and teeth need to be treated before the surgery. Infections in your gums or anywhere in your mouth may be hidden or inactive (even if you have lost your teeth), so your dentist needs to check your status.

4. Pay attention to nutrition and weight

Pay attention to nutrition by eating a well-balanced and healthy diet. Make sure you are getting enough vitamin D, calcium and protein. Good nutritional status will speed up your recovery process and improve your immunity. Overweight and malnutrition increase risks, slow down the recovery process, and shorten the life span of your joint replacement.

If you need advice or help with your diet or weight loss, consult a nutritionist or a nurse at your health centre. For more information on exercise groups, please contact a physiotherapist.

Make sure you stop taking any Omega-3 supplements and other natural health supplements at least two months before your surgery, as they increase the chance of bleeding during surgery.

5. Exercise regularly

Good overall health and strong muscles ease the symptoms of osteoarthritis, improve joint mobility and circulation, and speed up the recovery process after surgery. Regular and well-rounded exercise routines are important.

Increase the amount of exercise little by little, and use pain medication if needed. If the joint swells or feels substantially sore, try changing your exercise routine until the swelling or pain settles. If you need any help or support on exercise, please contact a physiotherapist at your health centre.

6. Take care of pain management

Make sure your pre-surgery pain management is taken care of. Cold therapy, exercise, rest, functional aids and a tailored pain medication help you get through your daily routines. A well-rounded pain management plan enables an active lifestyle. Both before and after your surgery, your doctor will ask you to describe your current pain level on a scale of 1–10.

7. Quit smoking

Quit using all tobacco products, including e-cigarettes, at least two months before your surgery.

Smoking will hinder your recovery and increase the risks related to anaesthesia and surgery:

  • the risk of blood clots is elevated
  • surgery-related breathing problems are 5 times more likely
  • wounds will heal more slowly and be more likely to caught infections
  • immunity against all infections is weakened
  • ossification is hindered

When you quit smoking:

  • Decide on a day.
  • If you wish to discuss replacement therapy or medication, contact your health centre.
  • Seek help and support from your health centre, family members, friends, colleagues, withdrawal support groups, a psychologist, a pharmacy, or call a support line.
  • (Stumppi support line, tel. 0800 148 484, Mon-Tue at 10:00-18:00, Thu at 13:00–16:00).
  • Prepare for withdrawal symptoms. They will occur within 2–12 hours after your last cigarette. They peak in the first few weeks, but you may still experience them 3–4 weeks or even months after quitting.

8. Quit all substances

If you are under influence of alcohol or drugs, your surgery will be cancelled. It is strictly forbidden to use any substances during the last 24 hours before you come to the hospital.

Heavy and regular drinking as well as drugs need to be abandoned at least two months before your surgery. If you find this hard or wish to talk about that, seek help and support from a substance abuse worker at your health centre.

It is important that you quit all substances:

  • the combined effect of alcohol, drugs and the medication used in the surgery may be fatal
  • substances increase the risk of accidents
  • withdrawal symptoms hinder the recovery process and rehabilitation

Alcohol as well as other substances make you more prone to accidents also during your recovery process.

9. Pay attention to mental well-being and sleeping

Mental well-being is a source of strength when you prepare for your surgery or are recovering from it. Pain, changes in your day-to-day life, and the forthcoming surgery may leave you feeling nervous, scared or anxious, but it is perfectly normal. Discuss these things with your family and friends, or seek help from your health centre.

Try to get enough sleep and rest, as it will help you stay active and alert, and also speed up the recovery process after your surgery.

10. Make plans with your family and friends

Discuss the forthcoming operation with your family and friends, as their help is vital at all stages of your care. Make plans on how to manage at home after surgery and during the recovery process. Go through all day-to-day chores such as grocery shopping, cooking and cleaning, and agree on who is going to help you with them.

Sometimes the help from family and friends is not available, or they cannot provide enough help. In this case, seek information on the support services available in your home city or municipality. A nurse at your health centre will be happy to provide you with more information.

11. Make sure your home is accessible

Plan and make necessary preparations to make your home more accessible and safe for you. Pay attention to lighting, area rugs, slippery floors and anything you think may be unsafe or hard to do with functional aids.

12. Practice walking with crutches and the range of motion exercises

After your joint replacement operation, you will need crutches for walking. Practice using them before your surgery. You can collect a pair of crutches from the medical aid service at your health centre. Loaning is free of charge, and you don’t need a referral to get them.

Don’t forget to do your range of motion exercises, as they will maintain both motion and muscle tone.