Preparing for hip replacement surgery starts weeks before your actual procedure date and covers everything from medical testing to rearranging your living room furniture. The more you do ahead of time, the smoother your surgery and recovery will go. Most surgical teams recommend beginning preparation at least four to six weeks out, though some steps (like building strength and improving nutrition) benefit from an even earlier start.
Medical Clearance and Preoperative Testing
Your surgical team will schedule preoperative testing within 30 days of your surgery date. This typically includes blood work, an electrocardiogram, a chest X-ray, and a urine sample. If you have heart disease, diabetes, or other chronic conditions, you may need additional evaluations like a stress test or specialist clearance before your surgeon gives the green light.
One easily overlooked step: get any dental work done at least six weeks before surgery, and don’t schedule any more until three months after. Bacteria from dental procedures can enter your bloodstream and potentially infect your new joint. This is a real and well-documented risk, not an overly cautious recommendation.
Medications and Supplements to Stop
Several common medications increase bleeding risk during surgery and need to be paused beforehand. Your surgeon’s office will give you a specific timeline, but the usual list includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), and prescription blood thinners. Many over-the-counter pain relievers you might be taking for hip pain fall into this category, so don’t assume anything is safe to continue without asking.
Herbal supplements like fish oil, vitamin E, ginkgo, and garlic supplements can also thin your blood. Most surgeons want you to stop these at least one to two weeks before the procedure. Bring a complete list of everything you take, including supplements, to your preoperative appointment.
Building Strength Before Surgery
Exercise before hip replacement, often called “prehab,” is one of the most effective things you can do to speed your recovery. A systematic review of prehab programs found that patients who exercised before surgery walked farther, got out of chairs faster, and climbed stairs sooner than those who didn’t. One study showed prehab patients could climb stairs after about 6 days compared to over 7 days for those who skipped it. Another found prehab cut the need for post-surgery physical therapy sessions from roughly 9 to 7, saving hours of rehab time.
Effective prehab programs include a mix of leg strengthening (leg presses, resistance bands, chair rises), stretching, walking, and light cardiovascular exercise like stationary cycling. Even home-based programs work. The key is consistency over several weeks rather than intensity. If your hip pain limits certain movements, a physical therapist can design a program that works around your current limitations. Starting four to six weeks before surgery gives you enough time to see meaningful gains.
Nutrition That Supports Healing
Surgery creates enormous demand on your body’s repair systems, and what you eat in the weeks beforehand directly affects how well you heal. Protein is the priority. Experts recommend increasing your intake to 1.2 to 1.5 grams per kilogram of body weight per day, ramping up to 2.0 to 3.0 grams per kilogram during recovery. For a 170-pound person, that means roughly 90 to 115 grams of protein daily in the weeks before surgery. Start this increase two to four weeks out. Each meal should include a solid protein source: eggs, poultry, fish, Greek yogurt, or legumes.
Vitamin D plays a direct role in reducing post-surgical inflammation and improving strength. Taking 800 to 1,000 IU daily for six weeks before surgery has been shown to lower inflammatory markers and improve functional scores after joint replacement. If you haven’t had your vitamin D level checked, ask at your preoperative appointment. Many people are deficient without knowing it.
If you’re anemic or have low iron levels, oral iron supplementation (40 to 60 mg daily) started at least eight weeks before surgery can help optimize your blood counts and reduce the chance of needing a transfusion. Your preoperative blood work will flag this if it’s an issue.
Skin Preparation to Prevent Infection
Infection is the fastest-growing reason for hip replacement revision surgery, now accounting for nearly 22% of all revision procedures, up from about 8% two decades ago. Your surgical team will likely provide antiseptic cloths containing chlorhexidine gluconate (CHG) and ask you to use them for five days before surgery.
The protocol is straightforward: shower normally each evening, dry off completely, then wipe down your body with the CHG cloths, paying extra attention to the hip area. Don’t rinse afterward. Let the solution air dry on your skin. On the morning of surgery, shower and apply the cloths one final time. That’s six total applications. It sounds simple, but following this routine significantly reduces the bacteria on your skin at the time of the incision.
Understanding Your Anesthesia Options
You’ll typically choose between spinal anesthesia (which numbs you from the waist down while you stay awake or lightly sedated) and general anesthesia (which puts you fully to sleep). Both are safe and well-established for hip replacement.
Spinal anesthesia has a measurably lower complication profile. A large study published in The Journal of Bone and Joint Surgery found that general anesthesia was associated with a 31% higher rate of adverse events overall, along with higher rates of blood transfusion and longer time in the operating room (about 12 extra minutes). Serious complications like stroke and cardiac arrest, while rare with either method, occurred more frequently under general anesthesia. Spinal anesthesia carries a very small risk of post-procedure headache and an extremely rare risk of nerve injury (fewer than 4 in 100,000 cases).
Hospital stay length was similar regardless of anesthesia type. Your anesthesiologist will discuss which option makes the most sense given your health history, but if you have no strong contraindication, spinal anesthesia is the lower-risk choice for most people.
Preparing Your Home
You’ll be on your feet with a walker or crutches within hours of surgery, but bending, reaching, and navigating obstacles will be difficult for weeks. Setting up your home before surgery saves you real frustration and reduces fall risk.
Start with the essentials:
- Raised toilet seat or toilet safety frame. You’ll need to avoid bending your hip deeply, and a standard toilet is too low. Grab bars next to the toilet add stability.
- Shower chair and grab bars. Standing showers are risky on one good leg. A shower chair with a long-handled sponge lets you bathe safely.
- Firm, supportive chairs. Place one in every room you’ll use. Low, soft couches are hard to get out of. You want a chair with armrests and a seat height that keeps your knees at or below hip level.
- Reacher/grabber tool. This extends your reach so you can pick things up off the floor, pull on pants, and grab items from low shelves without bending.
- Long-handled shoehorn and sock aid. Getting socks and shoes on is one of the hardest everyday tasks after hip surgery. These tools make it possible without help.
Clear all throw rugs, electrical cords, and clutter from walkways. Move frequently used items to counter or waist height so you don’t need to reach up or bend down. If your bedroom is upstairs, consider setting up a temporary sleeping area on the main floor. Make sure your bed is firm enough that you don’t sink in when sitting on the edge, and that your feet touch the floor when you sit. A portable commode on the same floor where you spend most of your day can save trips to the bathroom in the first week.
Attach a small bag or basket to your walker for carrying your phone, medications, and water. A backpack or fanny pack works well too, since your hands will be occupied.
What to Pack for the Hospital
Most hip replacement patients go home the same day or after one night. Pack light, but pack smart:
- Clothing: Loose-fitting shorts or pants with wide legs (no skinny jeans), a comfortable T-shirt or sweatshirt, and pajamas with short legs. You need to be able to dress without bending deeply.
- Footwear: Flat, non-skid shoes or well-fitted sneakers. No flip-flops or backless slippers.
- Documents: Your medication list with dosages and timing, advance directives, and insurance information.
- Medical devices: CPAP machine if you use one, inhalers, and any medications your team has told you to continue taking.
- Comfort items: Phone and charger, toiletries, and a knee-length robe for walking the halls.
The Week Before Surgery
In the final week, your preparation shifts to logistics. Confirm your ride home from the hospital, since you won’t be able to drive yourself. Stock your kitchen with easy meals and snacks that are high in protein. Pre-cook and freeze portions if possible. Fill any prescriptions your surgeon has called in so they’re waiting when you get home.
Practice using your walker or crutches before surgery day. Getting comfortable with the mechanics while you’re pain-free and clear-headed is far easier than learning for the first time while groggy after anesthesia. If you live alone, arrange for someone to stay with you or check on you daily for at least the first few days. You’ll be mobile, but tasks like cooking, laundry, and carrying things will require help initially.
Hip replacement produces some of the highest improvements in quality of life of any surgical procedure. Over 500,000 are performed in the United States each year, and implant durability has improved significantly, with loosening and wear now accounting for only about 21% of revisions compared to 34% a decade ago. The work you put into preparation directly translates into a faster, less complicated recovery.