Knee Replacement – Making Arrangements for Surgery

When you go for surgery, ask a family member or friend to go with you. Even when you are going for pre-admission, it’s a good idea to have someone with you. They can listen and take notes for you — or do some of the walking if that’s what you need! Be sure to give your family or friend plenty of notice about your upcoming tests and surgery.

Make a list of all medicines you are taking and any allergies to medicine or food that you have. Take this list with you when you go to the hospital (for pre-admission and surgery) so you won’t forget anything when asked.

Pre-admission Procedures

A few days before surgery, you will need to have certain tests and be “pre-admitted” to the hospital. This pre-admission visit can take several hours. Your surgeon’s office staff will tell you where to go and which tests you will need. If you have had any of these tests recently, tell your surgeon. A copy of your test results may do in place of retaking the tests. You may need:

  • A chest x-ray to see how well your lungs are working.
  • An electrocardiogram (EKG) that shows how your heart is working.
  • Blood tests that show chemistry and blood counts.
  • A urine analysis to show how your kidneys are working.

During pre-admission you will be asked:

  • To fill out insurance forms or provide authorization forms from your insurance company;
    be sure to bring your insurance card(s).
  • If you brought lab test results, paperwork from the blood bank, or written orders from
    your surgeon.
  • The name, address, and telephone number of someone to contact in case of an emergency.
  • To list your medicines, including the dosage and when you take them.
  • To list your food and drug allergies and how you react to each.

You will be told about your rights for advanced directives, which are your written directions for your care should you become unable to make decisions. If you have a living will and health care power-of-attorney, bring a copy of these with you. If you have any questions about advanced directives, ask to talk with a social worker.


An anesthesiologist may talk with you during your pre-admission visit. She will ask about your past history with anesthesia and if you are allergic to any medicines. The anesthesiologist will explain the type of anesthesia that will be used during surgery. There are two methods of anesthesia normally used for this type of surgery. You will either be numb in a specific area (regional anesthesia) or completely asleep (general anesthesia). With regional anesthesia, a specific part of the body is numb — such as from the waist down. Regional anesthesia includes epidural anesthesia (medicine injected into your back) and spinal anesthesia (medicine is placed
in the spinal canal). With general anesthesia, you will be completely asleep during surgery. An anesthesiologist or nurse anesthetist will be present at all times during your surgery.

If you take daily insulin, heart, or blood pressure medicine, ask the anesthesiologist when you should take your medicine the day before and morning of surgery. To help control nausea, the anesthesiologist may give you medicine to take before surgery.

Blood Transfusion

With today’s advanced surgical methods, blood loss during surgery is usually only 1 to 2 units. However, you may still need a blood transfusion. If so, the blood you receive will be matched with blood that has been carefully tested. The blood can come from:

  • Yourself (autologous blood donation) – you donate blood at a local blood bank or the
    hospital. Many surgeons prefer this method because it is the safest for you. Usually, you can
    donate up to 3 units at 1-week intervals beginning 3 to 4 weeks before surgery.
  • A designated donor – this can be a family member who has blood compatible with yours.
  • A blood bank – blood is supplied by the American Red Cross.

Ask your surgeon which would be best for you. If you or a designated donor give blood, the last donation must be completed at least 48 hours prior to surgery. Also, if you donate blood, be sure to eat and drink as directed to help rebuild your blood before surgery.

The Night Before Surgery

You must stop eating and drinking by midnight the night before surgery. This keeps the stomach empty which will reduce nausea and vomiting. You may be given special soap and asked to scrub your knee the night before and the morning of your surgery. Do not put lotion or cream on your knee after washing.

Total Knee Replacement

Table of Contents