Preparing for knee replacement surgery

Exercise before surgery

A review of 29 randomized trials found that exercise programs before knee replacement ("prehab") were linked to better function and less pain after surgery, and home-based programs did especially well.¹ Ask your surgeon or a physical therapist for a program that suits you, and practice walking with a walker or cane before surgery.²

Health steps that lower your risk

• Stop smoking. Tobacco use roughly doubles the risk of joint infection, and former smokers had lower risk than current smokers.³
• Blood sugar. Diabetes is linked to higher infection risk, so work with your doctor to get it well controlled.⁴
• Weight. Obesity is linked to more infection and revision, especially at very high BMI.⁵
• Medicines. Review every medicine and supplement with your team, especially blood thinners.
• Skin and teeth. Tell your team about any skin sores near the knee or dental problems, which can be infection risks.

Get your home ready

• Arrange help for the first week or two.⁶
• Set up a living space on one floor if you can, with a firm chair that has arms.
• Clear walkways, remove loose rugs and add night lights.
• Consider a raised toilet seat, a shower chair and grab bars. See recovery supplies.
• Put everyday items at waist height so you don't have to bend or reach.
• Prepare meals ahead and arrange rides, since you won't drive for several weeks.

What to bring to the hospital

• Loose shorts or pants that fit over a bulky dressing
• Supportive, closed-back shoes with non-slip soles
• Your medication list and insurance information
• Your walker, if you were given one beforehand

Sources

1. Wang Z, et al. Effectiveness of preoperative rehabilitation compared with usual care in total knee arthroplasty: a meta-analysis of randomized controlled trials. Arch Phys Med Rehabil. 2026;107(2):315-332. doi:10.1016/j.apmr.2025.08.022
2. MedlinePlus. Knee joint replacement. medlineplus.gov/ency/article/002974.htm
3. Bedard NA, et al. Tobacco use and risk of wound complications and periprosthetic joint infection: a systematic review and meta-analysis of primary total joint arthroplasty procedures. J Arthroplasty. 2019;34(2):385-396.e4. doi:10.1016/j.arth.2018.09.089
4. Gao H, et al. Factors associated with periprosthetic joint infection following total knee arthroplasty: an updated systematic review and meta-analysis. Arch Orthop Trauma Surg. 2026;146(1). doi:10.1007/s00402-026-06492-0
5. Onggo JR, et al. Greater risk of all-cause revisions and complications for obese patients in 3 106 381 total knee arthroplasties: a meta-analysis and systematic review. ANZ J Surg. 2021;91(11):2308-2321. doi:10.1111/ans.17138
6. Johns Hopkins Medicine. Knee replacement surgery. hopkinsmedicine.org