Pre Surgery Checklist Joint Replacement

Dr. Leo Zalikha’s team guides you through each step of preparation. This checklist covers the key items to address before your surgery date.

4 to 6 Weeks Before Surgery

The four-to-six-week mark is when the most important preparation begins. Three things happen in this window: your medical team confirms you are safe for surgery, you build strength ahead of your operation, and you address the health factors that influence healing. Here is what to focus on:

Medical Clearance:

Your primary care physician will perform a pre-operative medical evaluation to ensure you are safe for surgery. This may include:
Blood work (complete blood count, metabolic panel, coagulation studies).
Electrocardiogram (EKG) if indicated by your age or medical history.
Review of your medication list.
Assessment and optimization of chronic conditions (diabetes, hypertension, heart disease).
Evaluation of your dental health (active dental infections should be treated before joint replacement). Dr. Zalikha's office will provide specific clearance requirements and coordinate with your medical team.

Begin Prehabilitation:

Start strengthening exercises to improve your baseline fitness. Stronger muscles and better conditioning before surgery lead to faster recovery after it. Focus on:
Quadriceps and hip strengthening exercises.
Core stability work.
Walking or low-impact cardiovascular exercise within pain tolerance.
Upper body conditioning (to help with walker and cane use after surgery).

Optimize Your Health:

Smoking: Stop smoking at least four weeks before surgery. Smoking significantly impairs wound healing and increases infection risk.
Weight: If your BMI is elevated, even modest weight loss improves surgical outcomes.
Blood sugar: If you have diabetes, work with your physician to optimize glucose control. Elevated hemoglobin A1c levels are associated with higher complication rates.
Nutrition: Ensure adequate protein intake to support wound healing. Vitamin D and iron levels may be checked.

Medication Review:

Discuss your medications with Dr. Zalikha's office. Some medications may need to be adjusted:
Blood thinners: Specific instructions will be provided for stopping and restarting anticoagulants.
Anti-inflammatory medications (NSAIDs): Usually stopped before surgery to reduce bleeding risk.
Supplements: Certain supplements (fish oil, vitamin E, herbal products) may affect bleeding and should be discussed.
Immunosuppressants and biologics: Timing around surgery must be coordinated.

1 to 2 Weeks Before Surgery

Prepare Your Home:

Set up your living space for safe and comfortable recovery:
Remove tripping hazards: Rugs, cords, clutter in walkways.
Prepare a recovery area: A comfortable chair with armrests, a bed at a convenient height, a nightstand within reach for medications, water, and phone.
Kitchen prep: Stock easy-to-prepare meals and snacks. Prepare freezer meals if possible.
Bathroom: Consider a raised toilet seat and shower chair or grab bars. These are especially helpful in the first two weeks.
Mobility path: Ensure clear walking paths through the house, wide enough for a walker.

Arrange Support:

Confirm a responsible adult will be with you for the first 24 to 48 hours after surgery.
Arrange transportation to and from the surgical facility.
If you have pets that need care, plan accordingly.
Notify your employer about your expected time away from work.

Complete Required Appointments:

Pre-operative appointment with Dr. Zalikha's office (typically within two weeks of surgery).
Anesthesia evaluation (may be done by phone or in person).
Pre-admission testing at the surgical facility if required.

The Night Before Surgery

Follow fasting instructions. Typically, no food after midnight. Clear liquids may be allowed up to two hours before your arrival time (specific instructions will be provided)
Shower with the prescribed antiseptic soap
Do not shave the surgical area (the surgical team will handle this if needed)
Lay out comfortable, loose-fitting clothing for discharge day
Set your medications aside; bring them with you
Confirm your ride to the facility

What to Bring on Surgery Day

Photo ID and insurance card
A list of current medications. (names, dosages, timing)
Completed patient forms (if not already submitted)
Comfortable clothing for going home: Loose-fitting shorts or sweatpants, a comfortable top, slip-on shoes with non-skid soles
Assistive devices: A walker will be provided or available at the facility. If you have your own, bring it
Charger for your phone
Leave valuables at home: Jewelry, watches, and unnecessary electronics should stay home

What NOT to Bring

Jewelry or watches (must be removed before surgery)
Valuables or large amounts of cash
Contact lenses (wear glasses on surgery day)
Nail polish or acrylic nails (interferes with oxygen monitoring)

Day of Surgery: What Happens

You arrive at the surgical facility at your scheduled time
You change into a surgical gown and an IV is placed
The anesthesia team administers your anesthetic (typically spinal block with sedation)
Surgery takes approximately 60 to 90 minutes
You recover in the post-anesthesia care unit
A physical therapist works with you on standing and walking
You are discharged home (same day for outpatient cases) or to a hospital room for an overnight stay

Detailed information about what happens after surgery is available on the post-operative instructions page.

Dr. Zalikha’s team will guide you through every step of preparation. Schedule your consultation or call (562) 362-5024.

Pre-Op Checklist for Joint Replacement