Once you've decided on a joint replacement, it's natural to count down the days. I encourage patients to use that time. “Prehab,” meaning exercise and preparation before surgery, gets you into the operation as strong and ready as possible.
What the research shows
A review of 22 randomized trials with 1,601 patients looked at exercise before knee and hip replacement.1 For knee replacement, prehab reduced pain before surgery and shortened the hospital stay by about half a day on average. Improvements in function and quality of life after surgery were small and not statistically significant, and there was little measurable effect for hip replacement.
So prehab isn't magic, and it won't replace good surgery and good rehabilitation. But it's low-risk, it helps you feel better while you wait, and it prepares you for the work after surgery. The AAOS strongly recommends exercise for knee arthritis in general.2
A practical prehab checklist
- Strengthen your thigh and hip muscles. Quad sets, straight-leg raises, bridges and side-lying leg lifts are simple to do at home. A physical therapist can tailor a program to you.
- Keep moving. Walking, a stationary bike or pool exercise keeps your heart and muscles in shape without stressing the joint.
- Work on your upper body. You'll rely on your arms with a walker or cane, and when getting out of a chair.
- Practice with your walking aid before surgery, if you'll be using one.
- Get your health in order. Control blood sugar, stop smoking, and work toward a healthy weight. Each of these lowers surgical risk.
- Prepare your home. Clear tripping hazards, add a night light, put everyday items at waist height, and line up help for the first week or two.
- Schedule your physical therapy in advance so it starts on time.
Prehab and same-day surgery
Patients who prepare well are often the ones who go home quickly. If you're interested in same-day joint replacement, prehab is part of the plan.
Have questions about getting ready? Request a consultation.
- De Klerk TC, et al. The efficacy of prehabilitation before total hip and knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. Bone Jt Open. 2023;4(5):315–328.
- American Academy of Orthopaedic Surgeons. Management of Osteoarthritis of the Knee (Non-Arthroplasty): Evidence-Based Clinical Practice Guideline, 3rd ed. 2021.
This article is for general education and is not medical advice. Talk with your surgeon about your own situation.