Making the decision to have surgery to improve your life is a major step in the process. Without a doubt, you have been struggling for quite some time. Our team of surgeons, physician assistants, nurse practitioners, and administrative assistants are here to guide you through this process.


The testing and clearances that we request are an attempt to minimize the risks of surgery. In preparation for surgery, you will need:

  • Updated Labs
    • Complete Blood Count (CBC)
    • Basic Metabolic Panel (BMP)
    • Staph nasal swab
    • Urinanalysis
    • Hemoglobin A1c (if diabetic) – must be below 7.5
    • Serum albumin and total lymphocyte count (history of bariatric surgery or malnutrition)
  • Chest Xray
  • EKG
  • Medical Clearance – primary care and cardiology/pulmonology (if applicable)

You may also be asked to obtain additional imaging in preparation for your surgery. This may include additional X-rays with sizing markers or a specialized MRI.


  • Exercise – it is important to be in the best possible overall health to help promote the ideal surgical experience. Increasing upper body strength is important because of the need to use a walker or crutches after hip or knee replacement. Strengthening the lower body is also key because increasing leg strength before surgery can reduce recovery time.
  • Have a dental examination – although infections after joint replacement are not common, an infection can occur if bacteria enter the bloodstream. Therefore, dental procedures such as extractions and periodontal work should be completed before joint replacement surgery. We recommend 3 months after surgery before any post-operative dental cleaning or procedures.
  • Limit use of narcotics – there is an association with preoperative opioids and more postoperative pain. Whenever possible, this can be improved by limiting their use leading up to surgery
  • Stop certain medications – you will learn which specific medications need to be stopped prior to surgery when you come to Pre-Admission Testing for your Pre-Operative appointment. If you are taking blood thinners, they will need to be stopped prior to surgery.
  • Stop smoking – a good idea at any time, but particularly before major surgery in order to help reduce the risk of postoperative lung problems and improve healing.
  • Lose weight – in patients who are obese, losing weight will help reduce stress on the new joint. There is a markedly increased risk of complications in patients with a BMI >35.
  • Attend the Joint Class – this is a class at Mount Auburn or New England Baptist that will walk you through the experience of joint replacement and familiarize you with the post-surgical surroundings. There is a very strong correlation between patients attending this class and a more successful surgical outcome.
  • Evaluate post-surgical needs for at-home care – every patient who undergoes total joint replacement will need help at home for the first few weeks, including assistance with preparing meals and transportation.