The Waiting Game: What To Do Before Joint Replacement Surgery (Spirit of Women Magazine)

Painful, arthritic hips, knees or shoulders can make even the simplest movements impossible. 

To regain mobility, more people in their 40s, 50s and 60s are deciding joint replacement surgery (arthroplasty) is the smartest choice. And if you’re in your 70s or 80s, joint replacement can allow you to continue to live independently. 

“If you are having pain walking and you’re having trouble sleeping at night, think about joint replacement. It’s a personal decision, and you’ll know when it’s right for you,” says Brian Wegman, MD,, board-certified orthopedic surgeon and hip and knee replacement specialist at St. Luke’s Hospital. 

Making the decision for surgery isn’t the end of the story, however. If your procedure isn’t able to be scheduled right away, you may face weeks or months of discomfort while you wait for your surgery date.

Don’t worry, says Dr. Wegman. “Having to wait won’t drastically wear away the cartilage in your joint any more than you already have or make surgery more difficult,” he explains. But it can buy you time to get yourself in better shape for the surgery. Use this bonus time to improve your chances of a successful surgical outcome by taking some important steps.

To help control joint pain and swelling, your first line of defense is nonsteroidal anti-inflammatory drugs (NSAIDs). They work by blocking cyclooxygenase-2 (COX-2), an enzyme (protein) that the body produces when joints are injured. NSAIDs are available both by prescription and over the counter as Advil or Motrin (ibuprofen) or Aleve (naproxen). NSAIDs come in about 20 different strengths and formulas, so your doctor can help you find the best NSAID for you. 

“In my experience as an orthopedic surgeon, I’ve found that sometimes one anti-inflammatory will work for one patient but not for another,” Dr. Wegman says. “You may need to try multiple options before finding one that’s effective.” 

Along with NSAID therapy, apply ice or heat to the painful joint. “Both options work equally well. Use the method that makes you feel better,” Dr. Wegman says.  

If you haven’t exercised much lately or ever, it’s not too late to start. Stronger quadriceps (thigh muscles), hamstrings and tendons (fibrous tissue that attaches muscle to bone) before knee or hip replacement surgery can help you get back on your feet faster afterward, with better range of motion. 

“Every joint is supported by muscle-tendon units. If the muscles surrounding that joint are weak, your recovery from joint replacement surgery might take longer,” says Matthew Collard, MD, a board-certified orthopedic surgeon at St. Luke’s Des Peres Hospital.

Instead of just exercising on your own, however, work with a physical therapist, either in person or via telemedicine, to learn exercises that target specific muscle groups. If you’re waiting for shoulder replacement surgery, for example, a physical therapist can recommend a workout to condition the rotator cuff, which is a muscle deep inside the shoulder that stabilizes the shoulder joint. “The therapy department at St. Luke’s Des Peres Hospital offers pre-operative joint replacement classes where you can learn exercises that can condition the muscles that stabilize your knee joint and help improve recovery after surgery,” Dr. Collard says.

If you’re among the 34.2 million adults in the United States who smoke, the lag time before surgery is a great time to quit. In fact, your orthopedic surgeon may refuse to operate until you do. “I strongly encourage my patients to quit at least 4 weeks before surgery and 4 weeks after surgery because smoking affects the circulation to the soft tissue and that can delay healing and increase the chances for infection,” Dr. Collard says.

Quitting smoking can be challenging. To increase your chances of success so you can undergo joint replacement surgery as scheduled, get professional help. You can call the national tobacco quit line at 1-800-QUIT-NOW (1-800-784-8669) or join an online stop-smoking program such as the American Lung Association’s Freedom From Smoking (Freedomfromsmoking.org). To reduce nicotine withdrawal, try smoking cessation aids too, such as nicotine gum, patches, inhalers, lozenges and sprays, and non-nicotine medications such as Zyban (bupropion) or Chantix (varenicline).