Preparing for Surgery
Preparing well for your operation is one of the most important things you can do to help ensure a smooth procedure and a quicker, safer recovery. Mr Dennis Kosuge, Consultant Orthopaedic Surgeon, has brought together his own patient information booklets, practical guidance and trusted resources on this page to help you prepare for your hip or knee surgery with confidence. If you have any questions before your operation, Mr Kosuge and his team will be glad to help.
Mr Kosuge’s patient information booklets
How to prepare — your guidance
Prehabilitation — getting fit for surgery
Mr Kosuge believes that optimising your physical and mental wellbeing before an operation leads to better outcomes. Staying active within the limits of your joint, strengthening the surrounding muscles and preparing mentally all help you recover more quickly. The tools below support your “prehabilitation”.
Joint School (mobile phone app) →
Good Boost (online individually tailored exercises) →
Exercises before Joint Replacement Surgery (American Association of Hip and Knee Surgeons) →
Health and nutrition
Your general health affects your risk of complications during and after surgery. Modifiable factors such as blood pressure, diabetes and weight are best improved beforehand, and good nutrition supports healing afterwards. The resources below can help.
Smoking
Smoking slows wound healing and increases the risk of infection and other complications after surgery. Stopping, even for a few weeks around your operation, makes a real difference. For support:
Frequently asked questions
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The right time is a decision you make together with Mr Kosuge. In general, joint replacement is considered when pain and loss of function are significantly affecting your daily life and sleep, and when non-surgical measures are no longer giving adequate relief. There is no need to wait until the pain is unbearable, nor to rush if your symptoms are still manageable. Mr Kosuge will help you weigh the benefits against the risks for your individual situation.
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All surgery carries some risk. For hip and knee replacement these include infection, blood clots (deep vein thrombosis and pulmonary embolism), bleeding, stiffness, nerve or blood-vessel injury, a difference in leg length and, less commonly, dislocation or the need for further surgery. Serious complications are uncommon, and Mr Kosuge takes a number of measures to reduce these risks. He will discuss the risks most relevant to you, and how they are minimised, before you decide to proceed.
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Preparation makes a real difference. Staying as active as your joint allows, strengthening the muscles around it, maintaining a healthy weight, eating well, stopping smoking and keeping conditions such as diabetes and blood pressure well controlled all help you recover more quickly and safely. This is sometimes called prehabilitation. The resources on this page are designed to support you with each of these.
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Some supplements and herbal remedies can affect bleeding or interact with anaesthetic medications, so it is important that your surgical and pre-operative assessment team know everything you are taking, including vitamins, supplements and herbal products. They will advise you which to continue and which to stop, and when. Please do not stop any prescribed medication without advice.
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Before your operation you will attend a pre-operative assessment clinic to make sure you are as fit and well prepared as possible for surgery. It usually involves a review of your medical history and medications, routine tests such as blood tests, blood pressure and sometimes a heart tracing (ECG), and screening for infection. It is also a good opportunity to ask any questions about your admission and recovery.
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You will be given specific instructions about when to stop eating and drinking before your operation, which medications to take, and what time to arrive. Please follow these carefully, bring a list of your medications and any walking aids you use, and arrange for someone to take you home when you are discharged. Your team will confirm the exact arrangements with you beforehand.
Pre-operative videos
Knowing what to expect is one of the best ways to feel calmer and more in control before an operation. Mr Kosuge recommends watching the relevant videos below before your hip or knee surgery — they explain what will happen, how to prepare, and how to give yourself the best possible recovery. The Joint School videos are produced by The Rivers Hospital, Sawbridgeworth, so they show you the very place and team who will be looking after you.
Useful resources
Anaesthetic
The Royal College of Anaesthetists have an excellent Patient Information section. Specifically:
Anaesthetic choices for hip or knee replacement →
Making a decision
National Joint Registry (NJR) Patient Decision Support Tool →
Next: Recovering from Surgery
You have prepared for your operation — here is what to expect afterwards, from your first days at home through to getting back to the things you enjoy.
Book a Consultation / Further questions
Mr Kosuge would be glad to answer any questions you may have before surgery — the more prepared you are, the smoother your recovery tends to be.
To arrange a consultation, please call 01279 602675 or use the online booking link below.
NHS referrals to The Princess Alexandra Hospital, Harlow are also accepted via your GP.