Total joint arthroplasty, commonly known as hip replacement surgery, is a highly effective procedure for alleviating chronic hip pain and restoring mobility. The success of this operation relies heavily on thorough preparation and strict adherence to pre-operative instructions. Ignoring certain prohibitions can significantly elevate the risk of complications, including excessive bleeding, infection, and adverse reactions to anesthesia. Understanding what not to do in the weeks leading up to your surgery ensures a smooth procedure and an optimal recovery.
Medications and Supplements to Halt
A primary concern before any major surgery is managing medications that affect the body’s clotting ability. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, must be discontinued, typically seven days before the scheduled procedure. These pain relievers inhibit platelet function, increasing the risk of significant blood loss during and after surgery.
The same risk applies to prescription blood thinners, or anticoagulants, which include medications like warfarin, apixaban, and rivaroxaban. The exact timing for stopping these requires a personalized plan developed by your surgeon and the prescribing physician, often involving bridge therapy. Aspirin, even the low-dose variety, must also be stopped one week to ten days before surgery, as its effect on platelets is irreversible. Failing to discuss all prescription and over-the-counter drugs with your care team puts you at risk for serious surgical complications.
Patients should also cease taking most vitamins and herbal supplements for at least seven to fourteen days before the operation. Many supplements, including fish oil, ginger, garlic, ginseng, and high-dose Vitamin E, interfere with blood clotting. Other herbs, such as St. John’s Wort and kava, can negatively interact with anesthetic agents, potentially causing prolonged sedation or blood pressure instability. Stopping supplements mitigates the risk of excessive bleeding and unpredictable drug interactions.
Activities That Invite Infection
Introducing bacteria into the bloodstream before joint replacement poses a severe threat to the implant’s long-term success. Patients must avoid elective dental work, which can cause a transient presence of bacteria in the blood, for a specific period before surgery. Routine cleanings, fillings, or extractions should be completed at least four weeks prior to the surgery date to allow for complete tissue healing.
Procedures that break the skin barrier, such as new tattoos, piercings, or aggressive cosmetic treatments, must also be avoided in the weeks leading up to the operation. These activities create entry points for bacteria that could travel through the bloodstream and colonize the new joint, leading to infection. Any existing skin conditions, including rashes, cuts, or infections near the surgical site, must be reported immediately. The presence of an active infection requires the surgery to be postponed until the condition has fully resolved.
Lifestyle Habits to Stabilize or Cease
Systemic habits that compromise the body’s ability to heal or respond to anesthesia must be addressed well in advance. Quitting all forms of nicotine and tobacco use is a requirement for many surgeons. Nicotine constricts blood vessels and decreases oxygen delivered to the tissues, significantly impairing wound healing and increasing the risk of wound complications.
Cessation should begin as early as possible, as quitting four weeks or more before surgery substantially lowers the risk of pulmonary and infectious complications. Heavy alcohol consumption should also be limited or eliminated because it can impact liver function, which metabolizes anesthetic drugs. Drastic attempts at weight loss, such as crash dieting, should be avoided, as they can lead to nutritional deficiencies and electrolyte imbalances that complicate recovery.
Physical Risks and Symptom Neglect
Patients must refrain from any high-impact or strenuous physical activity that could risk injury to the already compromised hip joint. A pre-operative fracture or severe ligament tear could result in the cancellation or significant alteration of the planned procedure. Continue with gentle, prescribed exercises to maintain muscle strength, but avoid engaging in activities that could lead to a sudden fall.
Environmental hazards in the home, such as loose rugs, poor lighting, or unstable railings, should be corrected to prevent pre-operative accidents. Ignoring or delaying the reporting of new health symptoms is prohibited. A fever, persistent cough, cold symptoms, or any localized infection signals that the body is fighting an illness. Proceeding with surgery while the body is immunocompromised increases the risk of a severe post-operative infection, necessitating postponement until the patient is medically cleared.