Orthopedic Surgery Pre-Op Guide

Before your surgery

Orthopedic preparation has two halves. The medical half is your surgeon's: the tests, the imaging, the anaesthetic review and the decisions about your medicines. The practical half is yours, and it is the one patients most often underestimate. Building strength beforehand, clearing infection risk and setting up a home you can actually move around in all change how the first weeks feel.

Pre-surgery preparation

1. Complete your preoperative tests. Your surgeon arranges the checks that confirm you are fit for the procedure and let them plan it accurately. These usually include blood tests, an ECG, and imaging of the joint such as weight-bearing X-rays, with a CT or MRI scan where it is needed. A review with the anaesthetist covers your medical history and the type of anaesthesia planned.
2. Clear any source of infection first. Bacteria anywhere in the body can travel to a new implant, so your surgeon will want any active infection treated before surgery. Have a dental check-up before you travel, and tell your surgeon about gum problems, skin breaks, ingrown toenails, athlete's foot, leg ulcers or urinary symptoms. Your surgeon decides whether treatment is needed first and whether the date should move.
3. Review your medicines with your prescriber. Tell your surgeon about every medicine, supplement and herbal product you take, including blood-thinning medicines such as warfarin, apixaban or aspirin, anti-inflammatory painkillers, and any diabetes medication, along with any drug allergies. Do not stop or change a prescribed medicine unless the healthcare professional who prescribed it tells you to. Your surgeon and your prescriber will tell you whether and when anything needs to be paused, and when to restart it.
4. Get in the best shape you can beforehand. Stopping smoking, even a few weeks ahead, improves wound healing and lowers the risk of complications after bone and joint surgery. If you have diabetes, well-controlled blood sugar matters for both healing and implant infection risk. Your surgeon may also check for and treat anaemia or low iron before you travel, and may discuss your weight, which affects anaesthesia and the load on a new joint.
5. Start your prehabilitation exercises. Prehabilitation is the strengthening work you do before surgery, and it matters: the stronger your muscles are going in, the more you have to draw on afterwards. Ask your surgeon or physiotherapist for a programme. It usually builds the muscles around the joint, works the upper body for crutches, and includes practising with the crutches or walker you will use.
6. Set up your home for a mobile recovery. Arrange the practical things before you fly, because you will be less mobile when you get back. Have crutches or a walker ready, consider a raised toilet seat and a firm chair with arms, clear trip hazards such as loose rugs and trailing cables, move everyday items to waist height, and arrange for someone to help at home in the first weeks.
7. Pack your imaging, reports and the right footwear. Bring your recent X-rays, scans and any specialist reports, plus a written list of your medicines with their doses. Pack loose clothing that fits over dressings, shorts or loose trousers for physiotherapy, and flat, supportive shoes with a good grip and a back to them rather than backless slippers.

Prehabilitation: why the work before surgery matters

Prehabilitation, or prehab, is the conditioning you do in the weeks before your operation. It matters because recovery draws on the strength you already have, and research in joint replacement suggests patients who arrive stronger and fitter tend to regain function sooner and cope better with the early weeks. It also gets the awkward parts out of the way: learning to use crutches is far easier before your leg hurts than after. Your surgeon or physiotherapist gives you a programme suited to your joint and your condition. It usually includes:

• Strengthening the muscles around the joint, such as the quadriceps and glutes for a knee or hip, with the specific exercises your physiotherapist sets.
• Working your arms and upper body, because crutches and a walker are carried by your shoulders and hands.
• Practising with the crutches or walker you will use afterwards, including stairs if you have them at home.
• Ankle pumps and gentle circulation work, which are also among the first things you will do after surgery.
• Keeping active in whatever way your joint tolerates, such as swimming, cycling or walking in a pool, if your surgeon agrees it is suitable for you.
• The breathing exercises used after a general anaesthetic, which help keep your chest clear.
• Starting early. A few weeks of consistent, gentle work is worth far more than one hard week just before you fly.

During your surgery

Most orthopedic procedures are performed under general or spinal anaesthesia, and many joint replacements are done with a spinal anaesthetic and sedation, often with a nerve block for pain relief afterwards. A knee or hip replacement usually takes 1 to 2 hours with a hospital stay of a few days, while a bunion correction takes around 45 to 90 minutes and is often a day case or a single night. Your surgeon and anaesthetist confirm the technique, the anaesthesia and the length of stay for your case.

What to bring and how to prepare on the day

• Follow the fasting instructions your surgeon and anaesthetist give you exactly, including whether to take any morning medicines with a sip of water.
• Bring your imaging, reports and written medication list, and bring your medicines in their original packaging.
• Wear or pack loose clothing that fits over dressings, plus flat, supportive shoes with a good grip.
• Bring your crutches or walker if you already have them, so the physiotherapy team can set them to your height.
• Leave jewellery at the hotel and avoid nail polish on fingers and toes, so your circulation and oxygen levels can be monitored.
• Bring cases for glasses, hearing aids or dentures, and remove them before surgery as instructed.
• Tell the team straight away if you feel unwell, have a temperature, or notice any new skin break or infection in the days before your operation.

After your surgery

Recovery from orthopedic surgery is active rather than passive. After most joint replacements the physiotherapy team has you standing or taking your first steps within a day, because early, controlled movement protects your circulation, your joint and your strength. Your surgeon gives you detailed instructions covering how much weight you may put through the limb, wound care, pain relief and your exercise programme.

Post-op care

• Get moving as instructed. Early mobilisation with the physiotherapy team lowers the risk of blood clots, chest infection and stiffness.
• Follow your weight-bearing instructions precisely. Your surgeon tells you how much weight the limb can take and when that changes.
• Do your physiotherapy exercises every day. The exercise programme, not the operation alone, is what rebuilds movement and strength.
• Keep the wound clean and dry, and follow your surgeon's instructions on dressings and when you may shower.
• Watch for signs of wound infection: increasing pain, redness spreading from the wound, heat, discharge or a temperature. Contact your surgeon promptly.
• Take blood-clot prevention seriously. Wear the compression stockings, do your ankle pumps, stay well hydrated, and use any anti-clotting medication exactly as your surgeon prescribes, for as long as they prescribe it.
• Learn the warning signs of a clot: pain, swelling, warmth or redness in one calf, and above all sudden breathlessness or chest pain. Breathlessness or chest pain is an emergency and needs immediate medical help, not a phone call to the clinic.
• Manage pain properly rather than pushing through it, because pain control is what allows you to do the physiotherapy that drives your recovery.
• Use ice and elevation for swelling, which is normal for weeks after joint surgery and often worse at the end of the day.

Flying home and continuing your recovery

Flying is the part of orthopedic medical travel that needs the most planning. Sitting still for hours after surgery on a hip, knee, leg or foot raises the risk of a blood clot, and swelling is often worse at altitude. That makes the flight home a clinical decision rather than a booking decision, and it is one your partner surgeon makes, not Luna.

• Your partner surgeon confirms when it is safe for you to fly, usually after a follow-up check in Istanbul. Do not commit to a fixed return date on an assumption; Luna arranges your travel around your surgeon's clearance.
• Ask your surgeon what clot prevention you need for the flight itself, such as compression stockings, prescribed medication, or a specific plan for the day of travel.
• In the air, keep the circulation going as far as your surgeon allows: ankle pumps every hour, walking the aisle when it is safe to stand, and plenty of water rather than alcohol.
• Book an aisle seat or extra legroom so you can straighten the limb and stand up without climbing over anyone.
• Request airport mobility assistance when you book. Wheelchair support through check-in, security and boarding is free of charge, and airlines usually ask for at least 48 hours' notice. Luna arranges this and your transfers with you.
• Carry your discharge summary, implant details and medication list in your hand luggage, never in the hold. Ask your surgeon for an implant card or letter: security will still screen you, but the paperwork explains the metal.
• Arrange your physiotherapy at home before you travel. Most of your rehabilitation happens after you land, and a gap of several weeks costs you progress you then have to win back.
• Keep your follow-up appointments, including any review X-rays, and stay in contact with your partner surgeon through your Luna coordinator.

Orthopedic recovery rewards preparation and patience. The stronger and better organised you are before surgery, and the more consistently you do your physiotherapy afterwards, the better placed you are to follow the recovery your surgeon has planned with you.