How to Prepare for Knee Surgery: Complete Pre-Op Checklist

Everything you need to do before knee replacement or ACL surgery — medical prep, home setup, pre-hab exercises, and what to bring to the hospital.

Medical Preparation (4-6 Weeks Before)

Get medical clearance: Your surgeon will require clearance from your primary care doctor. This includes blood work, EKG (if over 50), and review of all medications.

• Stop blood thinners (warfarin, aspirin, ibuprofen) as directed — typically 7-14 days before
• Continue heart and blood pressure medications as normal
• Diabetes patients: optimize blood sugar (A1C below 7.0 reduces infection risk by 50%+)
• Disclose ALL supplements — some (fish oil, vitamin E, ginkgo) increase bleeding

Stop smoking: Smokers have 2-3x higher complication rates. Stop at least 4 weeks before surgery. Even stopping 2 weeks before helps wound healing.

Dental clearance: Get a dental checkup. Untreated dental infections can seed bacteria to your new joint implant — a serious complication. Fix any cavities or gum issues before surgery.

Pre-Hab: Exercise Before Surgery

Patients who exercise before surgery recover faster. Your surgeon or physical therapist can design a pre-hab program. Focus on:

• Quad strengthening: Straight-leg raises, wall slides, mini squats — your quad is the most important muscle for knee recovery
• Range of motion: Heel slides, knee bends — go in with as much range as possible
• Upper body strength: You'll rely on your arms for walker/crutch use
• Cardio conditioning: Walking, swimming, or cycling to improve overall fitness

Even 2-4 weeks of pre-hab makes a measurable difference in recovery speed.

Home Setup

• Bed or recliner where you'll sleep the first 1-2 weeks
• Side table for water, medications, phone, remote
• Clear paths (no rugs, cords, or clutter)

• Raised toilet seat (critical — standard height is too low after knee surgery)
• Grab bars near toilet and shower
• Shower chair or bench
• Non-slip mat

• Stock easy meals (frozen meals, sandwich supplies, snacks at counter height)
• Move frequently used items to counter level (no bending or reaching)
• Fill prescriptions in advance

Ice machine: Ask your surgeon about a cold therapy device (Breg Polar Care, Game Ready). These circulate cold water around your knee continuously and are far more effective than ice packs. Many are covered by insurance or available for rent ($200-$400).

What to Bring to the Hospital

• Photo ID and insurance card
• Medication list
• Advance directive (if applicable)
• Surgeon's pre-op instructions

• Loose shorts or sweatpants (must fit over knee bandage/brace)
• Slip-on shoes (no laces — you can't bend to tie them)
• Comfortable shirt

• Phone and charger
• Glasses (leave contacts at home)
• CPAP machine if you use one
• Book, tablet, or headphones

Do NOT bring: Jewelry, valuables, large amounts of cash, contact lenses.

Night Before and Morning Of

• No food or drink after midnight (or as directed by anesthesia)
• Shower with antibacterial soap (Hibiclens) — your surgeon may provide this
• Get a good night's sleep (take a mild sleep aid if needed, as approved by surgeon)
• Set out your go-home clothes

• Shower again with antibacterial soap
• Take approved medications with a small sip of water
• Leave jewelry and valuables at home
• Arrive at the time specified (usually 2 hours before surgery)
• Your support person should plan to stay at the facility during surgery (1-3 hours)

Frequently Asked Questions

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