How to Prepare for Knee Replacement Surgery – Complete Guide from Nagpal Robotics

Proper preparation before knee replacement surgery is one of the most important factors determining how smooth your surgery and recovery will be. At Nagpal Robotics in Bathinda, Punjab, Dr. Parampreet Singh Nagpal's team provides every patient with a comprehensive, personalised pre-operative preparation plan — covering medical optimisation, physical conditioning, home preparation, and mental preparation. This guide summarises everything you need to know to prepare for successful knee replacement surgery.

Step 1: Medical Tests and Health Optimisation

Pre-Operative Blood Tests

Before knee replacement surgery, Dr. Nagpal's team orders a complete pre-operative workup:

• Complete Blood Count (CBC) — to check for anaemia and infection
• Blood Sugar Fasting and HbA1c — critical for diabetic patients
• Kidney Function Tests (KFT) — to assess renal health before anaesthesia
• Liver Function Tests (LFT)
• Coagulation Profile (PT/INR) — to assess bleeding risk
• Blood Grouping and Cross-Matching — for potential transfusion needs
• Urine Analysis — to rule out urinary tract infection before surgery

Cardiac Assessment

• ECG (electrocardiogram) for all patients
• Echocardiogram for patients with cardiac history or above 65 years
• Cardiology clearance if needed

Chest X-Ray

Standard pre-operative chest X-ray to assess lung health before anaesthesia.

Dental Check-Up

Untreated dental infections can spread to the bloodstream and infect the new knee implant. A dental check-up and treatment of any active dental disease before surgery is strongly recommended.

Step 2: Medication Management

Dr. Nagpal provides specific instructions about medications before surgery:

• Blood Thinners (warfarin, clopidogrel, aspirin): Stopped 5–7 days before surgery to reduce bleeding risk
• Anti-inflammatory drugs (NSAIDs): Stopped 1 week before surgery
• Diabetes medications: Adjusted as per the anaesthesia team's guidance — typically held on the morning of surgery
• Blood pressure medications: Usually continued until the morning of surgery with a small sip of water
• Herbal supplements: Many can affect bleeding or anaesthesia — stop 2 weeks before surgery
• Steroid medications: Continue as prescribed; inform Dr. Nagpal's team of all steroid use

Step 3: Pre-Operative Exercise – "Prehabilitation"

Stronger muscles before surgery lead to faster, better recovery after surgery. Dr. Nagpal recommends the following exercises in the weeks before knee replacement:

• Quadriceps Sets: Tightening the thigh muscle while the leg is flat — 10–20 times per hour
• Straight Leg Raises: Lifting the straight leg off the bed — 3 sets of 10–15
• Heel Slides: Sliding the heel towards the buttocks while lying down
• Ankle Pumps: Moving the foot up and down to promote circulation
• Short Arc Quads: Straightening the knee from 30 degrees to full extension
• Seated Knee Flexion: Bending and straightening the knee while seated

These exercises are safe for most patients but should be performed within comfortable pain limits. Dr. Nagpal's physiotherapy team provides personalised guidance.

Step 4: Weight Management

Reducing body weight before surgery — even by 5–10 kg — significantly reduces surgical risk, post-operative complications, and the load on the new knee joint. Dr. Nagpal provides dietary guidance to help patients achieve a healthier weight before surgery.

Step 5: Home Preparation

Preparing your home before surgery makes recovery safer and more comfortable:

• Remove trip hazards: Clear loose rugs, cables, and clutter from walkways
• Install grab rails: In the bathroom, toilet area, and stairways
• Raised toilet seat: Makes standing up easier in the first weeks after surgery
• Shower chair or bath bench: For safe bathing during recovery
• Prepare a recovery room: Ideally on the ground floor to avoid stairs initially
• Stock supplies: Medications, ice packs, pillows for leg elevation
• Arrange transport: You will not be able to drive for 6–8 weeks after surgery

Step 6: Fasting Before Surgery

Follow Dr. Nagpal's specific fasting instructions:

• No food for at least 6–8 hours before surgery
• No water for at least 2–4 hours before surgery
• Take only prescribed morning medications with a very small sip of water

Step 7: What to Bring to the Hospital

• All medical reports, X-rays, and investigation results
• List of all current medications
• ID proof and insurance documents
• Comfortable, loose clothing — especially trousers that fit over a bulkier knee
• Non-slip slippers or shoes with good grip
• Personal hygiene items
• A trusted family member or caregiver

Frequently Asked Questions