Knee surgery: Pre-surgical optimisation

Preparing for knee surgery, whether it's a partial or total knee replacement or a ligament reconstruction, can significantly affect the outcome and speed of recovery. Optimisation before surgery involves identifying and managing any health factors that may influence how well a patient recovers, reduce the risk of complications, and improve the overall success of the procedure.

Why is pre-surgical optimisation important?

Knee surgery places physical demands on the body. Patients with certain medical conditions or lifestyle factors may face higher risks during or after surgery. By addressing these in advance, patients can enter surgery in the best possible condition, often resulting in:

Shorter hospital stays
Lower infection rates
Faster rehabilitation
Better long-term outcomes

What areas are typically addressed in optimisation?

Optimisation involves a multidisciplinary approach and is tailored to each patient’s needs. Key areas include:

Weight management: Excess body weight increases stress on the knee joint and can raise the risk of complications such as infection or delayed wound healing. Losing weight before surgery can reduce these risks and improve surgical precision.
Smoking cessation: Smoking interferes with circulation and tissue healing. Patients are strongly advised to stop smoking well before surgery to lower the risk of post-operative complications.
Diabetes and blood sugar control: Poorly managed diabetes can lead to delayed healing and increased infection risk. Optimising blood sugar levels reduces these risks.
Management of other chronic conditions: Conditions such as hypertension, heart disease, or anaemia should be stabilised with the help of a GP or specialist.
Nutritional status: Good nutrition supports immune function and tissue repair. Nutritional supplements may be recommended in cases of deficiency.
Exercise and physiotherapy: Prehabilitation, or structured physiotherapy before surgery, can help strengthen the muscles around the knee and improve mobility. This can lead to a smoother post-operative recovery.

What lifestyle changes can help?

In addition to medical optimisation, making healthy lifestyle adjustments can contribute to better surgical outcomes:

Engage in low-impact exercise such as swimming or cycling to build strength and maintain joint flexibility.
Enjoy a balanced diet that includes vitamins and protein.
Reduce alcohol intake, which can interfere with healing and interact with medications.

Pre-operative assessments and planning

Patients typically undergo a pre-operative assessment that may include blood tests, imaging, and a review of medications. This assessment identifies any risks and allows time to implement necessary changes.

You should inform your surgeon about all medications and supplements, as some may need to be stopped or adjusted before the operation.

It’s also useful to practice using mobility aids such as crutches or walking frames because they may be needed after surgery.

A team-based approach to preparation

Successful optimisation often involves collaboration between orthopaedic surgeons, GPs, physiotherapists, anaesthetists and other specialists. This coordinated approach ensures the patient is fully prepared physically and mentally for surgery.

By taking active steps to optimise health before knee surgery, patients can increase the chances of a smoother operation and faster, more effective recovery