Preparing for hip replacement surgery starts weeks before your actual procedure date, and the work you put in beforehand directly affects how smoothly your recovery goes. Most preparation falls into a few key areas: building strength, setting up your home, adjusting medications, and handling the medical screenings your surgical team will order. Here’s what to expect and what to do at each stage.
Start Strengthening Exercises 4 to 10 Weeks Out
The stronger your muscles are going into surgery, the faster you’ll recover afterward. Pre-surgical exercise programs (often called “prehab”) typically run two to three sessions per week for four to ten weeks before your procedure. The core exercises focus on the muscles surrounding your hip and knee: leg presses, knee extensions, leg curls, hip abductions (pushing the leg outward), hip adductions (pulling the leg inward), and hip extensions (pushing the leg backward). Calf raises and seated leg raises round out most programs.
These sessions are best done under supervision, at least initially, so a physical therapist can make sure you’re using proper form and not aggravating your hip. Your surgeon’s office can refer you to a therapist who specializes in joint replacement prehab. Even if your surgery is only four weeks away, starting now is better than skipping it entirely.
Medical Screening and Blood Work
Your surgical team will order preoperative blood tests to check for issues that could complicate surgery or recovery. These typically screen for kidney function, hemoglobin levels (to assess anemia risk), liver function, and markers of inflammation. Abnormal results become more common with age, particularly for kidney function and hemoglobin, so older patients may need additional follow-up before getting cleared.
Depending on your age and health history, you may also need cardiac clearance, especially if you have a history of heart disease or high blood pressure. Some surgeons require a dental exam beforehand, since untreated dental infections can seed bacteria into the bloodstream and potentially infect your new joint. Ask your surgical coordinator exactly which clearances you need so you can schedule them with enough lead time.
Medication Changes Before Surgery
If you take blood thinners, your doctor will give you a specific timeline for stopping them. The windows vary significantly depending on the medication. Warfarin is typically stopped five days before surgery. Newer blood thinners like rivaroxaban and apixaban are usually stopped 48 hours before, though people with kidney problems may need to stop 72 hours ahead. Clopidogrel and prasugrel require a longer pause of seven to ten days.
Standard anti-inflammatory painkillers like ibuprofen or naproxen generally don’t need to be stopped for the surgery itself, but your surgeon may have specific preferences. The important thing is to never adjust or stop any medication without your surgical team’s explicit instructions. Bring a complete list of everything you take, including supplements, to your pre-surgical appointment.
Quit Smoking at Least 6 Weeks Before
If you smoke, this is one of the most impactful things you can do for your outcome. The American Academy of Orthopedic Surgeons recommends quitting four to six weeks before surgery, and many surgeons require a negative urine nicotine test six weeks prior. The difference is stark: in one study, patients who didn’t stop smoking had a 27% rate of wound complications or infection, compared to just 5% among those who quit before surgery. That includes nicotine patches and vapes, not just cigarettes. Talk to your doctor about cessation aids if you need help.
Set Up Your Home for Recovery
You won’t be able to bend deeply at the hip for several weeks after surgery, and you’ll be using a walker or cane. Making your home safe and functional before you leave for the hospital saves you real frustration later.
In the bathroom, install a raised toilet seat, which keeps you from bending your hip past its safe range. Add grab bars secured vertically or horizontally to the wall near the toilet and the tub. Do not rely on towel racks for support. They aren’t designed to hold your weight. A shower chair lets you bathe safely without standing on a wet surface.
Throughout the house, remove throw rugs, loose cords, and anything else you could trip over. Fix uneven flooring in doorways. Move items you use daily to counter height so you don’t have to reach up or bend down. If your bedroom is upstairs, consider setting up a temporary sleeping area on the main floor for the first few weeks.
Gather Adaptive Tools and Pack Your Bag
A few inexpensive devices make a big difference when you can’t bend over easily. A reacher or grabber tool lets you pick things up off the floor or pull items off shelves. A long-handled shoehorn and a sock aid (a simple device that lets you slide socks on without bending) will save you daily frustration. You can buy these online or at most pharmacies, and some hospitals lend them out.
For the hospital, pack loose-fitting clothes that are easy to pull on without bending, like elastic-waist pants or shorts. Bring a knee-length robe and slip-on shoes with non-skid soles. Avoid anything that requires tying laces or reaching down to your feet. You’ll also want your insurance information, medication list, and any documents your surgical coordinator requested.
Nutrition in the Weeks and Days Before
Your body needs protein to heal surgical wounds and rebuild muscle. In the weeks leading up to surgery, aim for 1.2 to 1.5 grams of protein per kilogram of body weight each day. For a 170-pound person, that’s roughly 90 to 115 grams daily. During the recovery period after surgery, needs climb even higher, to 2.0 to 3.0 grams per kilogram per day, so building the habit of protein-rich meals beforehand helps. Good sources include chicken, fish, eggs, Greek yogurt, beans, and protein shakes if you’re having trouble hitting targets through food alone.
On the day of surgery, current guidelines from the American Society of Anesthesiologists allow a light meal six to eight hours before your procedure, ideally something with complex carbohydrates and lean protein to stabilize blood sugar. You can drink clear liquids up to two hours beforehand. The old rule of “nothing after midnight” has largely been replaced by these more flexible guidelines, but follow whatever your specific surgical team tells you, since individual instructions may vary based on your health.
Skin Preparation to Prevent Infection
The night before and the morning of surgery, wash the skin around your hip with 2% chlorhexidine cloths (often sold under the brand name Hibiclens). Your surgical team may provide these or tell you where to buy them. This antiseptic wash significantly reduces the bacteria on your skin and lowers your risk of surgical site infection. Let the solution air-dry rather than rinsing it off, and don’t apply lotion, powder, or deodorant to the area afterward.
Plan Your Ride and Early Recovery Support
You’ll need someone to drive you home from the hospital, which for most hip replacements means one to three days after surgery. For the first one to two weeks at home, plan to have someone available to help with meals, getting dressed, and basic household tasks. If you live alone, arrange this help in advance, whether it’s a family member staying with you, a friend rotating visits, or a short-term home health aide. Stock your kitchen with easy-to-prepare meals and put a cooler or small table next to your recovery chair so essentials are within arm’s reach.