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Preparing for hip replacement surgery starts about six weeks before your operation, not the week of it. After more than twenty years and over 700 joint replacements a year, I can tell you the patients who struggle are rarely the ones with the worst X-rays. They are the ones who arrived unready.
The operation takes about an hour. The six weeks before it are up to you. Here is what I tell my patients in Franklin, Nashville, Columbia, and across Middle Tennessee.
How far in advance should you start preparing for hip replacement surgery?
Start about six weeks out. That window covers medical clearance, medication changes, dental work, and getting your house ready without a last-minute scramble. Here is the countdown I hand patients when we set a date.
| When | What to do |
|---|---|
| 6 weeks out | Finish dental work. Start walking or pool exercise. Cut back nicotine and alcohol. Confirm insurance and time off work. |
| 4 weeks out | Complete preoperative labs, EKG, and medical clearance. Review every medication and supplement with my office. |
| 2 to 3 weeks out | Order recovery equipment. Rearrange the house. Stock the freezer. Confirm your driver and your helper. |
| 7 days out | Stop NSAIDs and most supplements as directed. Stop blood thinners only on your prescriber’s schedule. |
| Night before | Wash with the antiseptic soap provided. Nothing to eat or drink after the time we specify. Pack your bag. |
What medical clearance do you need before surgery?
Most patients need blood work, a urine sample, an EKG, and a clearance note from their primary care doctor within 30 days. Heart, lung, or kidney conditions may add a specialist visit.
Those results catch what quietly raises risk: anemia, high blood sugar, a silent urinary infection. If your hemoglobin A1c (a three-month average of blood sugar) runs high, we work on that first. High blood sugar around the time of surgery is linked to a higher infection risk, and it is one of the few risk factors we can actually move before your date.
Which medications and supplements should you stop?
Stop anti-inflammatory medicines such as ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin seven days before surgery unless I say otherwise. They thin the blood and increase bleeding.
Stop most supplements too: vitamin E, fish oil, ginkgo, ginseng, turmeric, and glucosamine all affect clotting more than people realize. Acetaminophen (Tylenol) is fine to continue.
Blood thinners are different. If you take warfarin, apixaban, or clopidogrel, never stop on your own. The prescribing doctor sets that schedule, and my office coordinates it.
Bring your actual pill bottles to your preoperative visit. A written list misses something almost every time.
Why the dentist matters when preparing for hip replacement
Finish dental work at least two to four weeks before hip replacement surgery, and hold off on elective dental procedures for about three months afterward. Bacteria from an infected tooth or inflamed gums can enter the bloodstream and settle on a new implant.
How do you get your body ready for surgery?
Four changes matter most: stop nicotine, treat your blood sugar, moderate alcohol, and move every day. None require a gym membership.
Nicotine. Smoking and vaping narrow blood vessels and slow healing in skin, bone, and muscle. Quitting at least four weeks before hip replacement surgery measurably lowers wound complications and infection risk. If you cut back but cannot stop, tell me anyway; I would rather know.
Weight. Extra weight raises the risk of infection and wound problems. I am realistic about this: your hip hurts, so exercise is hard. Pool walking, a stationary bike, and portion control are the three that work for my patients.
Alcohol. Cut back in the weeks beforehand and stop entirely in the final days. Alcohol increases bleeding and dehydrates you.
Protein and iron. Healing needs building blocks. If your blood count is low, we may start iron so you have more reserve.
Which exercises help most before hip replacement surgery?
The most useful prehabilitation exercises are glute squeezes, quad sets, straight leg raises, gentle hip abduction, and upper body work with light bands. Ten to fifteen minutes a day is enough.
The upper body work surprises people. You will push up out of chairs and lean on a walker, and those are shoulder tasks.
Practice with your walker and cane before surgery, not after. If an exercise makes your hip sharply worse, stop and let us know. Preparing for hip replacement should never mean pushing through pain.
How should you prepare your home for hip replacement recovery?
Walk through your house the way you will move through it on day one: slowly, with a walker, hands full. Every obstacle you find is a fall waiting to happen.
- Clear the paths. Remove throw rugs, tape down cords, and move furniture so a walker fits through every doorway.
- Set up one home base. A firm chair with armrests, a side table, a charger, water, the remote, and your medications within reach.
- Solve the stairs. If your bedroom is upstairs, plan to sleep downstairs for the first week or two. Most patients manage stairs sooner than they expect.
- Fix the bathroom first. This is where falls happen. Grab bars by the toilet and tub, a shower chair, a non-slip mat.
- Stock up. Freezer meals, canned goods, pet food, and a two-week supply of anything you take regularly.
What equipment do you actually need?
Five items cover almost everyone: a walker, a raised toilet seat, a shower chair, a grabber, and a long-handled shoehorn with a sock aid.
You do not need an expensive chair; cushions raise a seat just as well. Ask my office before buying, because some equipment comes through the surgery center and some is covered by insurance. Add an ice pack. You will use it more than any pill.
Who should you line up before surgery day?
You need three people: a driver, a helper for the first few days, and someone who knows your medical history well enough to speak for you.
Anesthesia and pain medicine make driving unsafe, so you will not drive for several weeks. Arrange rides for follow-up visits too.
If you live alone, tell us early. That one fact changes how we plan your discharge, and there are good options.
Handle the paperwork at the same time: insurance benefits, time off work, and pet care.
What happens the week and the night before?
The week before is about not getting sick and following instructions precisely.
- Wash with the antiseptic soap exactly as directed, usually the night before and the morning of surgery.
- Do not shave your leg or hip. Shaving creates nicks where bacteria live.
- Nothing to eat or drink after the time we give you. If you eat, surgery gets cancelled.
- Skip lotion, perfume, deodorant, and nail polish the morning of surgery. Leave jewelry and valuables at home, and bring a photo ID.
- Pack loose clothing, slip-on shoes with a closed back, a phone charger, and your walker if you have one.
- Take only the morning medications we approved, with a small sip of water.
What does preparing for hip replacement look like in my Franklin practice?
At the Bone and Joint Institute of Tennessee, preparation begins the day we set your date, not at a class weeks later.
Most of my hip replacements use the direct anterior approach, which works between the muscles at the front of the hip rather than cutting through them, and many use the Mako® robotic-assisted system for implant positioning. (Disclosure: I am a paid consultant for Stryker, which makes the Mako platform.) Both change what preparation looks like for you: fewer long-term movement restrictions, and often a same-day discharge.
My patients travel from Franklin, Brentwood, Nashville, Spring Hill, Columbia, Murfreesboro, and Nolensville. If your drive runs past 45 minutes, build that ride home into the plan.
More on the technique is on my anterior hip replacement page, or start with the total hip replacement overview.
When should you call your surgeon before hip replacement surgery?
Call us before surgery day if any of the following happens.
- Fever, cough, cold, flu, or a stomach bug in the week before surgery.
- Any cut, scrape, rash, or open sore on the surgical leg.
- Burning with urination or other signs of a urinary infection.
- A dental problem, especially pain or swelling around a tooth.
- Any confusion about which medications to stop or continue.
- Second thoughts. It is your hip and your timeline; rescheduling is always allowed.
None of these calls bother us; every one is easier to handle before surgery than after. Nerves the night before are normal and have no bearing on how the surgery goes.
What is the single best way to prepare for hip replacement surgery?
Start six weeks out and work the checklist above in order. Preparing for hip replacement surgery is not complicated, but it rewards starting early: six weeks, a short list, and one willing helper carry most of the load.
Schedule with Dr. Cory Calendine, MD
Bone and Joint Institute of Tennessee
3000 Edward Curd Lane, Franklin, TN 37067
(615) 791-2630
Medical disclaimer: this article is for education only and does not replace advice from a qualified orthopaedic surgeon or your own care team. Recovery varies by patient. Always follow the preoperative instructions your surgeon gives you.
References
- Duchman KR, Gao Y, Pugely AJ, Martin CT, Noiseux NO, Callaghan JJ. The effect of smoking on short-term complications following total hip and knee arthroplasty. J Bone Joint Surg Am. 2015;97(13):1049-1058. PubMed
- Moller AM, Villebro N, Pedersen T, Tonnesen H. Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet. 2002;359(9301):114-117. PubMed
- Chrastil J, Anderson MB, Stevens V, Anand R, Peters CL, Pelt CE. Is hemoglobin A1c or perioperative hyperglycemia predictive of periprosthetic joint infection or death following primary total joint arthroplasty? J Arthroplasty. 2015;30(7):1197-1202. PubMed
- Moyer R, Ikert K, Long K, Marsh J. The value of preoperative exercise and education for patients undergoing total hip and knee arthroplasty: a systematic review and meta-analysis. JBJS Rev. 2017;5(12):e2. PubMed
- Evans JT, Evans JP, Walker RW, Blom AW, Whitehouse MR, Sayers A. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):647-654. PubMed
