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    Learning About Your Health

    Total Knee Replacement: Prepare for Your Surgery

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    Note: Please review this information to help prepare for your surgery and recovery. We want you to be involved in your health decisions. Share this information with family, friends and caregivers.

    Each person has a different health condition. If you have any questions, please ask the doctors, nurses, and therapists caring for you.

    What is Total Knee Replacement?

    Your replacement knee joint will be made of various materials (including metal and plastic) depending on your particular needs. The new joint, called a prosthesis, consists of a metal cover and a plastic piece with a metal stem.

    Your surgeon will make an incision (cut) on the front of your knee. The end of your femur (thigh bone) is trimmed and resurfaced with a metal cover or shell. The end of the tibia (lower leg bone) is trimmed and resurfaced with a plastic and metal implant.

    The surgery takes about two hours, but a successful knee replacement begins long before you enter the hospital.

    Normal knee showing femur and tibia. Knee with prosthesis showing metal cover and plastic piece.
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    Your Surgery Checklist

    • Make an appointment with your primary care (regular) doctor: You need a physical exam 2-3 weeks before your surgery. Your primary care doctor makes sure you are healthy and ready for surgery.

      • Pre-registration is a two-step process that you must complete before having a surgery, test, or procedure at California Pacific Medical Center.
        1. Pre-Registration. Please call (855) 398-1637 within 1 – 2 weeks before your procedure to speak with a Patient Access representative. Please be sure to have your insurance card information ready when you begin.
        2. Health History. A nurse will take your health history, answer your questions, and explain what testing is necessary before your surgery, test, or procedure.

          Based on your health status, the nurse may send you to complete any required testing before you come to the hospital. The nurse will tell you where you can go for your test(s).
    • Check with your doctor:
      • About the medicines you are taking now. You may need to stop taking non-steroidal, anti-inflammatory drugs (NSAIDs), and any drugs that contain aspirin, one week before surgery.
      • About any medicine(s) you feel you must take the day of surgery.
      • If you are taking any herbal or over-the-counter medicines.
    • If your surgeon has told you to donate your own blood: Call your local blood bank to arrange for this. You may start donating blood 5 weeks before your surgery. Note: The blood bank may charge a fee for this service depending on your insurance coverage.

    • If you need any dental work: Ask your orthopedic surgeon, who may recommend the dental work be done before surgery to reduce the chance of infection after your surgery.

    • Eat a healthy diet.

    • Quit smoking: Speak with your doctor about quitting smoking, or call 1-800-NO-BUTTS (1-800-662-8887).

    • Start doing hip strengthening exercises (both legs): You'll recover faster if you begin strengthening your leg muscles before surgery with these special exercises: Ankle Pumps, Quad Sets, Gluteal Squeezes, Heel Slides, Short Arc Quads, Straight Leg Raises, Hip Abduction, Long Arc Quads, and Knee Slides.
    Note: Do 10 sets of each of the following exercises twice a day, unless your doctor tells you otherwise.

    Ankle pump exerciseAnkle Pumps
    Bend ankles to move feet up and down, alternating feet.

    Quad set exerciseQuad Sets
    Slowly tighten muscles on thigh of straight leg while counting out loud to 10.
    Repeat with other leg to complete set.

    Gluteal squeeze exerciseGluteal Squeezes
    Squeeze buttocks muscles as tightly as possible while counting out loud to 10.

    Heel slide exerciseHeel Slides
    Make sure bed is flat.
    Bend knee and pull heel toward buttocks.
    Hold for 10 seconds. Return. Repeat with other knee to complete set.

    Short arc quad exerciseShort Arc Quads
    Place a rolled towel under your knee. Raise the lower part of your leg until your knee is straight. Hold for 10 seconds.

    Straight leg raise exerciseStraight Leg Raises
    Bend one leg. Keep other leg as straight as possible and tighten muscles on top of thigh.
    Slowly lift straight leg 10 inches from bed and hold for 10 seconds.
    Lower it, keeping muscles tight for 10 seconds. Relax.

    Hip abduction exerciseHip Abduction
    Keep your toes pointed toward the ceiling. Move your leg out to the side as far as possible. Slowly return to the starting position and relax.

    Long arc quad exerciseLong Arc Quads
    Straighten operated leg and try to hold it for 10 seconds.

    Knee slide exerciseKnee Slides
    Slowly slide your foot forward in front of you until a stretch is felt in the knee and hold for 10 seconds. Then slide your foot back as far as you can and hold for 10 seconds.

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    Prepare Your Home Before Surgery

    • Before you go to the hospital, do your grocery shopping, prepare and freeze meals, and put cooking utensils where they are easy to reach. Make simple meals that will be ready for you when you get home.

    • Move furniture to make a clear path to your kitchen, bathroom, and bedroom. Many patients use a walker after leaving the hospital. This means you need more room to move around your home.

    • Remove small rugs so you do not trip.

    • You need a firm chair that has armrests to use after surgery. You should not sit in a chair that rocks, rolls, or swivels.

    • Place a non-skid bath mat in your tub or shower.

    • If you have stairs at home, count your stairs. When you come to the hospital, tell your physical therapist how many stairs you have and if you have a railing.

    • For convenience, you can place items that you use every day at arm level (between your waist and shoulders).

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    The Day Before Surgery


    • You may eat your regular diet until the night before your surgery.

    • Ask your doctor if you need to stop taking any of your regular medicines before surgery. Your surgeon or primary doctor may ask you to bring all of your medicines in the original containers to the hospital. Please give all medicines from home to the nurse. Your medicine will be returned to you when you are ready to go home.

    • Bring loose-fit clothing, non-skid closed shoes and toiletries.

    • Arrange for someone to drive you home from the hospital and stay with you at home that day and possibly longer.

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    The Day of Surgery

    Go Directly to the Campus Where Your Surgery is Scheduled

    Pacific Campus
    (415) 600-3480

    Ambulatory Care Unit (ACU)
    2351 Clay Street
    Stanford Building, 6th Floor

    California Campus
    (415) 600-2097

    Ambulatory Surgery Unit (ASU)
    3700 California Street, 3rd Floor

    Davies Campus
    (415) 600-5274

    Castro & Duboce Streets
    Admissions – Lobby Level, North Tower

    St. Luke's Campus
    (415) 641-6889

    Outpatient Surgery
    3555 Cesar Chavez Street, 3rd Floor

    • Patients are generally asked to arrive 1 - 2 hours before the scheduled surgery. Please confirm the arrival time with your surgeon's office.

    • Your care, comfort and privacy are our main concerns. Our goal is to make sure that your surgery is within 30 minutes of the scheduled time. Sometimes there are delays. We will keep you informed if delays occur.

    • Take only the medicines that you were told to by the nurse or surgeon/primary doctor - with a sip of water.

    • Wear loose, comfortable clothing. Bring cases for glasses, contact lenses, and dentures. You will need to remove them before your surgery.

    • Do not wear or bring wedding bands, other jewelry or body piercings, or valuables like cash, credit cards, or checkbooks. Pack a small overnight bag with your personal items, if needed.

    • Our standard discharge time is 11:00 a.m. Arrange for someone to drive you home.

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    Surgical Waiting Areas - For Your Convenience

    During your surgery, your family and friends may wait in the designated Surgical Waiting Areas. Staff will direct your family and friends to the designated areas as well as keep them well-informed.

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    More Ways to Learn

    Visit the Community Health Resource Center at 2100 Webster Street, San Francisco, (415) 923-3155. Services include classes and written information on a wide variety of health topics.

    Produced by the Center for Patient and Community Education in association with the Department of Outcomes Management and the Communications & Marketing Department at California Pacific Medical Center. Last updated: 7/09

    Illustrations by: Christine Gralapp and Troy Paiva

    Funded by: A generous donation from the Mr. and Mrs. Arthur A. Ciocca Foundation.

    Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).

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