Quick answer: To prepare for a joint replacement, use the waiting time to get fitter with strengthening exercise, manage your weight, stop smoking and keep alcohol within limits. Get diabetes, blood pressure and anaemia checked, and never stop arthritis medicines without advice. Attend your pre-operative assessment, then set up your home with help, equipment and easy meals before you go in.
Checked on 10 October 2026 against NHS pages on preparing for a hip replacement, preparing for a knee replacement and before surgery, the Royal College of Anaesthetists' Fitter Better Sooner guidance and NICE NG226. Always follow the specific instructions from your own hospital.
If you are waiting for a hip, knee or shoulder replacement, the weeks or months before surgery are not wasted time. The NHS says it is important to work on things such as strengthening exercises, weight, smoking and alcohol while you wait, because they may lower your risk of complications and speed up your recovery. The Royal College of Anaesthetists (RCoA) puts it simply: fitter patients who improve their health and activity recover from surgery more quickly.
This guide brings together what to do in the months, weeks and days before your operation, and how to get your home ready for the recovery.
Months before: get fitter for surgery
Keep active and build strength
The RCoA advises increasing your activity while you wait, aiming for activity that makes you a bit out of breath at least three times a week, starting slowly and staying within your limits. Swimming and cycling are often easier on painful hips and knees than walking. Strength and balance exercises, such as daily sit-to-stand practice from a chair, help with getting up and walking after surgery.
Ask your physiotherapist or hospital for exercises specific to your operation. Many hospitals give you the post-operative exercises in advance so you can practise them. Our exercise hub has joint-specific routines. If you are frail or find exercise very difficult, see our guide to prehabilitation for frailer adults.
Stop and get medical advice if exercise brings on chest pain, dizziness or an irregular heartbeat.
Weight
If you are living with overweight, losing some weight can reduce strain on your heart and lungs. The RCoA lists benefits including lower blood pressure and blood sugar, less joint pain, and a lower risk of blood clots and wound infections after surgery. NICE says that for people with osteoarthritis who are living with overweight or obesity, any amount of weight loss is likely to be beneficial. Your GP surgery or pharmacy can signpost local weight management support, and the NHS has a free Weight Loss Plan app.
NICE also says people should not be excluded from referral for joint replacement because of their age, smoking, other health conditions or weight measured by BMI alone. If you have been told you must lose a set amount of weight before surgery, ask the team to explain why and what support is available.
Stop smoking
The RCoA says quitting or cutting down even shortly before surgery can reduce your hospital stay and improve wound healing and lung function. Free help is available from local NHS Stop Smoking Services, and your pharmacist or GP can advise on stop smoking aids.
Alcohol
Alcohol reduces the body's ability to heal. If you drink, keep within the UK low-risk guideline of no more than 14 units a week spread over 3 or more days. If you drink more than this, cut down gradually before your operation and ask your GP for help. Stopping heavy drinking suddenly can be dangerous.
Eat well
Your body needs protein and a range of nutrients to repair itself. The RCoA recommends getting enough protein and at least 5 portions of fruit and vegetables a day. Our guide to the best foods to eat with arthritis has practical ideas.
Get your other health conditions checked
The RCoA recommends making sure any long-term conditions are as well controlled as possible before surgery, because this reduces the chance of your operation being delayed:
- Diabetes: good blood sugar control lowers your risk of infection. If you have not had an HbA1c test in the past six months, ask your GP surgery.
- Blood pressure: operations can be delayed if it is too high. Ask for a check if you have not had one in the last year. Some pharmacies offer this.
- Anaemia: treating low iron before surgery reduces the chance of needing a blood transfusion and helps recovery. Ask your GP for a blood test if you think you might be anaemic.
- Teeth and gums: see a dentist about loose teeth or crowns, and keep your mouth healthy to reduce infection risk.
- Skin: tell the team about any cuts, ulcers, eczema or infections, especially near the operation site, as these may need to heal first.
- Mental health: it is normal to feel anxious. If worry is affecting you a lot, talk to your GP. If you take medicine for your mental health, tell the pre-operative team.
Arthritis medicines and surgery
Many people having joint replacements take medicines that need planning around surgery, including:
- disease-modifying medicines such as methotrexate, and biologic or targeted medicines, which affect the immune system and infection risk
- steroid tablets, which may need extra cover around the operation
- anti-inflammatory painkillers (NSAIDs)
- blood thinners such as warfarin, apixaban, rivaroxaban or clopidogrel
- diabetes medicines
- herbal remedies and supplements
Do not stop any of these on your own. The NHS says the pre-operative assessment will give you clear information on whether to stop your usual medicines before going into hospital. Make sure the surgical team knows about every medicine you take, and ask your rheumatology team to liaise with them if you take DMARDs, biologics or steroids.
Weeks before: the pre-operative assessment
You will usually be asked to attend a pre-operative assessment, often a few weeks before the operation. The NHS describes this as an appointment with a nurse, in person or by phone or video, to check whether you have any medical problems that need treating first, or whether you will need special care.
Tests may include blood tests, a urine test for infection, an ECG to check your heart, blood pressure checks, X-rays and swabs for infections such as MRSA. You will be told:
- when to stop eating and drinking before the operation
- which medicines to stop or keep taking
- what to bring into hospital
- how long you are likely to stay
Many hospitals also run education sessions, sometimes called joint school, where you meet the team, learn about the operation and practise using crutches or a frame. If you are offered one, go, and take the person who will help you at home.
Get your home ready
The NHS and RCoA both recommend preparing for recovery before you go into hospital. Use this checklist:
- Arrange help with shopping, cleaning, laundry and any caring responsibilities for the first few weeks.
- Move everyday items to between waist and shoulder height so you do not need to bend or reach.
- Clear trip hazards such as loose rugs, trailing cables and clutter, and make sure there is good lighting, including at night.
- Stock the freezer with ready meals or batch-cooked food, or set up online shopping.
- Think about where you will sleep. If stairs are hard, you might sleep downstairs for a while, but the RCoA notes you will generally recover quicker if you keep moving.
- Check your chairs. A firm chair with arms, at a height where your hips are higher than your knees, is easier to get out of.
- Equipment. The NHS mentions items such as a raised toilet seat and a long-handled grabber. Your hospital occupational therapist may assess what you need and arrange some equipment. Ask before buying.
- Bathroom. Think about how you will wash. You may not be able to get into a bath for a while.
- Pets and dependants. Arrange care for pets, children or relatives you look after. Your local council or carer service can help if family cannot.
Work, driving and money
- Work: speak to your employer early. The NHS says many people return to work around 6 to 12 weeks after a knee replacement, depending on the job. Ask the hospital who will provide your fit note.
- Driving: the NHS says you will not be able to drive for at least 6 weeks after a hip replacement or a total knee replacement, or 3 weeks after a partial knee replacement, and you should check with your doctor that you are fit to drive. Arrange lifts to the hospital and to follow-up appointments. Tell your insurer, as some policies have conditions after surgery.
- Money: check your sick pay entitlement. In England, if you get certain benefits or qualify for the NHS Low Income Scheme, the Healthcare Travel Costs Scheme may refund reasonable travel costs to hospital appointments. Ask your hospital about the equivalent help in Scotland, Wales or Northern Ireland, and whether you are eligible for patient transport.
Days before: final preparations
- Follow your fasting instructions exactly. You may be allowed water or a carbohydrate drink; check with your team.
- Remove nail polish, gels, make-up and piercings, and shower or bathe as instructed. You may be given an antiseptic wash.
- Pack your medicines in their original packaging, with a list of doses.
- Pack loose comfortable clothes, sturdy but easy-on shoes or slippers with a back, glasses, hearing aid batteries, chargers and something to pass the time.
- Bring your admission letter and important phone numbers, including your GP's.
- Let the hospital know straight away if you develop a cough, cold or high temperature in the days before surgery.
What to expect afterwards
Many hospitals follow an enhanced recovery approach, aiming to get you drinking, eating and moving soon after surgery. The NHS says you will usually leave hospital 1 to 4 days after a knee replacement if there are no complications and you can get around safely with crutches. You will probably wear compression stockings to reduce the risk of blood clots, and you will have exercises to do at home. Full recovery can take several months or longer. Our hip replacement recovery guide explains the stages in more detail.
Differences across the UK
Preparation is similar across the UK, but waiting time rules differ. In Scotland, the 12-week Treatment Time Guarantee applies to planned inpatient and day-case treatment, including hip and knee replacements, once treatment is agreed. In England, the 18-week referral-to-treatment right applies, but the NHS notes it does not apply if delaying is in your best clinical interests, for example to lose weight or stop smoking first. See our waiting list guide for each nation's rules.
When to get medical help
Before surgery, contact your GP or the surgical team if your joint suddenly becomes much worse, red, hot or swollen, or you develop an infection anywhere in your body.
After surgery, the NHS says to ask for an urgent GP appointment or contact NHS 111 if you have:
- throbbing or cramping pain in your hip or leg
- a high temperature, or you feel hot, cold or shivery
- oozing or pus from your wound
- redness, tenderness, swelling or pain that is not getting better or is getting worse
Call 999 or go to A&E if you have pain and swelling in your leg together with difficulty breathing or chest pain, as this could be a blood clot in the lungs.
Frequently asked questions
What exercises should I do before a knee or hip replacement?
Ask your physiotherapist or hospital for exercises specific to your operation. General advice is to stay as active as you can, include strengthening such as sit-to-stand practice, and build up gradually.
Do I have to lose weight before a joint replacement?
Losing weight if you are living with overweight can lower some surgical risks and help recovery. NICE says people should not be excluded from referral because of weight measured by BMI alone. Ask your team what they recommend for you.
Should I stop my arthritis medicines before surgery?
Only if your surgical or rheumatology team tells you to. Some medicines are paused and others are continued. You will get specific advice at your pre-operative assessment.
How long will I be in hospital?
It varies. The NHS says people usually go home 1 to 4 days after a knee replacement if there are no complications. Your team will give you an estimate.
When can I drive after a joint replacement?
The NHS says at least 6 weeks after a hip or total knee replacement, or 3 weeks after a partial knee replacement, and only once your doctor confirms you are fit to drive. Check with your insurer too.
What equipment will I need at home?
Commonly a raised toilet seat, a long-handled grabber and sometimes a perching stool or chair raisers. Your hospital occupational therapist can advise and may arrange items for you.
Sources and further reading
- NHS: Preparing for a hip replacement
- NHS: Preparing for a knee replacement
- NHS: Recovering from a knee replacement
- NHS: Complications of a hip replacement
- NHS: Having an operation – before surgery
- Royal College of Anaesthetists: Preparing for surgery – Fitter Better Sooner
- NICE NG226: Osteoarthritis in over 16s – referral for joint replacement
- NHS inform: NHS Scotland waiting times
- NHS: Healthcare Travel Costs Scheme (HTCS)
- NHS: Alcohol units
Educational information for people in the United Kingdom, not personal medical, legal or financial advice. NHS processes, rules and prices change, so check the linked official sources and speak to your GP, specialist team or pharmacist about your own situation. Charity no. 1218461. Pending clinical review. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- Joint replacement surgery guide — types, benefits and risks
- Total knee replacement guide — what happens and recovery
- Questions to ask your consultant — before you agree to surgery
- Driving with arthritis — DVLA rules and returning to driving