What you need to do before hip replacement surgery

Hip replacement surgery requires planning that starts weeks before your operation date. Your surgeon will give you a timeline, usually four to six weeks out, that tells you when to stop certain medications, when to have pre-surgery blood work and imaging done, and when to arrange time off work. The hospital or surgical center will send you written instructions — follow them exactly, because missing a step can delay your surgery.

The core tasks are straightforward: get medical clearance from your primary care doctor, stop blood thinners and NSAIDs on the schedule your surgeon provides, arrange someone to drive you home and help for the first two weeks, and prepare your home so you can move safely on crutches or a walker. Most people also benefit from physical therapy before surgery, which strengthens the muscles around your hip and teaches you the movements you will need after.

Key Takeaways

  • Your surgeon will provide a written pre-surgery checklist with specific dates for stopping medications, blood work, and fasting — follow it exactly or your surgery may be postponed.
  • You must arrange a driver for the day of surgery and a caregiver for at least the first two weeks, because you will not be able to drive or live alone during recovery.
  • Pre-surgery physical therapy reduces pain after surgery and speeds your return to normal activity, so ask your surgeon whether to start before or after your operation date.
  • Prepare your home before surgery by removing tripping hazards, installing grab bars in the bathroom, and setting up a ground-floor bedroom and bathroom if possible.
  • Medical clearance from your primary care doctor is required; this visit catches infections or heart problems that could complicate surgery.

Medical tests and clearance before surgery

Your surgeon's office will order blood work, usually a complete blood count and metabolic panel, to check for anemia, infection, or kidney problems that could affect surgery or recovery. You will also have an EKG (heart tracing) if you are over 65 or have a history of heart disease. These tests typically happen one to two weeks before surgery.

You must see your primary care doctor for pre-surgery clearance. This is not optional — the surgeon will not proceed without it. Your primary care doctor checks your blood pressure, listens to your heart and lungs, and reviews your full medication list. If you have diabetes, sleep apnea, or heart disease, your doctor may order additional tests or adjust your medications before surgery.

Bring a list of all medications and supplements you take, including over-the-counter ones. Some supplements — fish oil, ginger, ginkgo, and vitamin E — thin the blood and must be stopped before surgery. Your surgeon will tell you which ones and when to stop them, usually five to seven days before the operation.

Medications to stop or adjust before surgery

Blood thinners like warfarin, apixaban, and rivaroxaban must be stopped before surgery because they increase bleeding during the operation. Your surgeon will tell you exactly when to stop — usually three to five days before surgery — and whether you need a bridge medication. Do not stop blood thinners on your own; call your surgeon's office if you are unsure of the timing.

NSAIDs (ibuprofen, naproxen, aspirin) also thin the blood and should be stopped one to two weeks before surgery. Acetaminophen is safe to take right up until surgery. If you take aspirin for heart protection, your surgeon may ask you to continue it or stop it — ask directly rather than guessing.

Bring all your medications in their original bottles to the hospital on surgery day. The surgical team needs to see the exact names and doses. If you take medications for diabetes, blood pressure, or thyroid disease, your surgeon will tell you whether to take them the morning of surgery or skip them that day.

Fasting and what to eat and drink before surgery

You will receive fasting instructions, usually to stop eating solid food at midnight the night before surgery and to stop drinking clear liquids two hours before your scheduled arrival time. This prevents food or liquid from entering your lungs while you are under anesthesia. Follow these instructions exactly — eating or drinking after the cutoff time can force the hospital to cancel your surgery.

Clear liquids include water, black coffee or tea (no milk), apple juice, and broth. Avoid milk, cream, orange juice, and anything with pulp. If you are unsure whether something counts as clear, call the surgical center the day before.

The night before surgery, eat a normal dinner. You do not need to eat extra or avoid certain foods — just eat what you normally would. After surgery, you will be able to eat soft foods within a few hours, so do not worry about being hungry for long.

Preparing your home for recovery

Before surgery, walk through your home and remove anything you could trip on: throw rugs, electrical cords, pet toys, and clutter on stairs. You will be using crutches or a walker for the first four to six weeks, and a fall during recovery can damage your new hip.

Install grab bars in the bathroom — one next to the toilet and one in the shower or tub. If you do not have a ground-floor bedroom and bathroom, set up a temporary bedroom on the main floor. Climbing stairs is difficult for the first month, and you want to avoid it if possible.

Stock your kitchen and freezer before surgery. Prepare or buy meals you can reheat easily — soups, casseroles, and prepared proteins. You will not feel like cooking, and your caregiver may not have time. Set up a small table or cart next to your bed or couch to hold water, medications, the remote control, and your phone so you do not have to get up repeatedly.

Physical therapy before surgery

Pre-surgery physical therapy, called prehabilitation, reduces pain after surgery and speeds your return to walking and normal activity. Your surgeon may recommend it or you may request it. If you start physical therapy, plan for two to three sessions per week for four to six weeks before surgery.

A physical therapist will teach you exercises to strengthen the muscles around your hip, show you how to use crutches or a walker safely, and explain the movements you will need to avoid after surgery (like crossing your legs or bending your hip more than 90 degrees). These lessons make the first weeks after surgery much easier because your body already knows what to do.

If your surgeon does not recommend pre-surgery therapy, you will start physical therapy one to two weeks after surgery instead. Either way, physical therapy is a core part of recovery and you should plan to attend sessions for eight to twelve weeks total.

Arranging help for the first weeks after surgery

You must have someone drive you home from surgery — you cannot drive yourself because of the anesthesia and pain medication. Arrange this person at least two weeks in advance. The drive home usually takes 30 to 60 minutes depending on distance.

For the first two weeks after surgery, you will need someone at home with you during the day. You cannot cook, clean, do laundry, or manage stairs alone. This person does not need to be a nurse — they need to help you move safely, prepare meals, and get to the bathroom. If you live alone, arrange for a family member, friend, or paid caregiver to stay with you or visit daily.

After two weeks, you may be able to manage alone during the day if your home is prepared and you have crutches or a walker. However, many people benefit from help for four to six weeks. Discuss your situation with your surgeon so you know what to expect.

What to bring to the hospital on surgery day

Bring your insurance card, photo ID, and any paperwork the hospital sent you. Wear loose, comfortable clothing that is straightforward to remove — you will change into a hospital gown. Leave jewelry, watches, and valuables at home. If you wear glasses or hearing aids, bring them in a labeled case so you can use them after surgery.

Bring a list of all your medications and any allergies. Bring your phone charger. Do not bring large amounts of cash. Arrive 60 to 90 minutes before your scheduled surgery time so the surgical team can check you in, review your medical history, and place an IV.

Frequently Asked Questions

Can I eat breakfast the morning of surgery?

No. Your surgeon will give you a fasting cutoff time, usually midnight for solid food and two hours before arrival for clear liquids. Eating after this time can force the hospital to cancel your surgery because food in your stomach increases the risk of aspiration during anesthesia.

What if I take blood pressure or diabetes medication?

Call your surgeon's office the day before surgery to ask whether to take these medications the morning of your operation. Some surgeons want you to take them with a small sip of water; others want you to skip them. Do not guess — the answer depends on your specific medications and medical history.

Do I need physical therapy before surgery or can I wait until after?

You can do either. Pre-surgery physical therapy (prehabilitation) reduces pain and speeds recovery, but it is not required. If you start before surgery, plan for four to six weeks of sessions. If you skip it, you will start physical therapy one to two weeks after surgery instead. Ask your surgeon which approach makes sense for your situation.

What if I cannot arrange a caregiver for the first two weeks?

Talk to your surgeon about your options. Some people hire a home health aide, arrange for family to take turns visiting, or move temporarily to a family member's home. A few hospitals offer short-term rehabilitation facilities where you can stay for one to two weeks after surgery while you recover. Your surgeon's office can discuss what is available in your area.

Can I drive myself home from surgery?

No. Anesthesia and pain medication impair your judgment and reaction time for at least 24 hours after surgery. You must have someone else drive you. If you cannot arrange a driver, tell the hospital before surgery day — they may be able to help you find a solution.