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Preparing for Surgery PDF Evidence

Illustration of a patient going through a checklist with a surgeon before an operation.
Preparing for your operation. Kieran Hirpara 4.0

General checklist for the days before upper-limb surgery — fasting, what to bring, medications.

What you're feeling

You may notice pain that flares up after you move your joint or at the end of the day. Many people find it hard to sleep on the side of the affected joint. You might feel stiffness when you first wake up in the morning. Simple tasks like reaching behind your back to fasten a bra or tucking in your shirt can become difficult.

Your surgeon knows that these symptoms are more than just numbers on an X-ray. We treat you as a whole person, not just your radiographic findings. This approach helps build trust and improves your outcome. While some patients feel their knowledge about joint replacement increases after a class, others may only see a modest change in understanding.

We want to prepare you for what comes next. A formal educational program can help lower how long you stay in the hospital after hip or knee replacement. We use proactive protocols to make sure your same-day discharge is safe and successful. If you have questions about pain, we may discuss video counseling to help lower your need for opioids in the first week after surgery.

What's actually happening

Your joint is like a machine that has worn down over time. Inside, the smooth coating on the bone ends, called cartilage, acts as a shock absorber. When this coating wears away, the bones rub together. This causes pain and stiffness. Your surgeon sees this on X-rays, but treats you as a person, not just a picture.

To help you prepare, your surgeon may use tools to explain what is happening. You might watch a video or look at a 3D model of your hip. These tools help you understand the problem before surgery. Some patients find that learning from others in a class helps them feel more ready. This can change how you expect your recovery to go.

Good preparation also helps your body heal faster. If you learn about pain medicine before surgery, you may need fewer opioids in the first week after your knee replacement. A formal education program can also help you leave the hospital sooner after a hip or knee operation. Your care team uses these plans to avoid problems when you go home the same day. This proactive approach keeps your experience safe and successful.

What we can do about it

You can start by managing your own pain and working with a physiotherapist. These steps aim to improve your movement and reduce discomfort before any procedure. While evidence for preoperative opioid education in hand surgery shows some benefit, the data is limited. For hip or knee replacement, a formal educational program can help lower your length of stay in the hospital. Your team will also use proactive office protocols to ensure a safe same-day discharge by anticipating potential problems.

Medical management involves pain medication, anti-inflammatories, and injections like cortisone, hyaluronic acid, or PRP. Preoperative video counseling can significantly decrease opioid consumption within the first week after total knee replacement. Classes can also modify your expectations of recovery from total hip or total knee replacement. However, knowledge about joint replacement increased only modestly for underserved patients in mission trips. Using 3D hip models for counseling does not appear to improve your understanding or satisfaction compared to standard CT imaging alone.

Surgery is considered when conservative care reaches its limit and daily life remains difficult. Your surgeon will discuss this option if your symptoms do not improve with the steps above. The operation replaces the damaged joint to restore function and relieve pain.

When to see someone

See your GP if you have persistent pain that does not improve with rest. Ask for a specialist review if you notice weakness, instability, or your joint locks and gives way. Seek help if symptoms interfere with your sleep or work, or if you experience sudden worsening. Your surgeon may use preoperative video counseling to help reduce opioid use in the first week after surgery. Formal education programs can also help lower your hospital stay for hip or knee replacement. These steps support a safe recovery and better understanding of your care.

Reviewed by Dr Kieran Hirpara · 2026-06-10 22:42:22.612856+00:00.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

title: "Preparing for Surgery" slug: preoperative-preparation region: recovery audience: patient mesh_terms: ["Preoperative Care", "Patient Education as Topic", "pre-op preparation", "day before surgery", "what to bring", "pre-admission"] article_count: 9 model_used: qwen3.5-35b-a3b-q8 generated_at: '2026-05-18T13:56:43+00:00' key_articles: - title: "The effect of preoperative interventions on postoperative outcomes following elective hand surgery: A systematic review" ref_num: 1 evidence_tier: paper evidence_level: 1 doi: 10.1177/17589983241301449 year: 2024 - title: "Patient Education Before Hip or Knee Arthroplasty Lowers Length of Stay" ref_num: 2 evidence_tier: paper evidence_level: 3 doi: 10.1016/j.arth.2009.03.012 year: 2010 - title: "Considerations for Office and Staff Protocols for Outpatient Joint Replacement" ref_num: 3 evidence_tier: paper evidence_level: 5 doi: 10.1016/j.arth.2019.01.001 year: 2019 - title: "Randomized Trials to Modify Patients' Preoperative Expectations of Hip and Knee Arthroplasties" ref_num: 4 evidence_tier: paper evidence_level: 1 doi: 10.1007/s11999-007-0052-z year: 2008 - title: "What’s Important: Treat the Patient Instead of the Disease" ref_num: 5 evidence_tier: paper evidence_level: 5 doi: 10.2106/jbjs.24.01274 year: 2025 - title: "Preoperative Patient Education Class During an Orthopedic Mission Trip: Effects on Knowledge, Anxiety, and Informed Consent" ref_num: 6 evidence_tier: paper evidence_level: 4 doi: 10.1016/j.arth.2020.04.084 year: 2020 - title: "Preoperative rehabilitation and education program for surgery (PREPS): A pilot randomized control trial protocol" ref_num: 7 evidence_tier: paper evidence_level: 2 doi: 10.1177/17589983251345393 year: 2025 - title: "Patient-Specific 3-Dimensional Modeling and Its Use for Preoperative Counseling of Patients Undergoing Hip Arthroscopy" ref_num: 8 evidence_tier: paper evidence_level: 2 doi: 10.1177/2325967118794645 year: 2018 - title: "The Efficacy of Preoperative Video-Based Opioid Counseling on Postoperative Opioid Consumption After Total Knee Arthroplasty: A Prospective Randomized Controlled Trial" ref_num: 9 evidence_tier: paper evidence_level: 1 doi: 10.1016/j.arth.2024.02.027 year: 2024 synthesis_version: "v2" verifier_status: skipped

Overview

  • Preoperative opioid education shows some indication of favourable outcomes following elective hand surgery, though the number of studies were small, evidence quality was poor, and data were limited [1].
  • A formal preoperative educational program can help to lower a patient's length of stay following hip or knee arthroplasty [2].
  • Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with same-day discharge [3].
  • Patients' preoperative expectations of their recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA) can be modified by preoperative educational classes [4].
  • Maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust [5].
  • Underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class during a surgical mission trip [6].
  • A pilot randomized controlled trial will evaluate the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement [7].
  • Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to femoroacetabular impingement (FAI) when compared with the use of CT imaging alone [8].

Anatomy & Pathophysiology

  • Preoperative opioid education shows some indication of favourable outcomes following elective hand surgery, though the number of studies were small, evidence quality was poor, and data were limited [1].
  • A formal preoperative educational program can help to lower a patient's length of stay following hip or knee arthroplasty [2].
  • Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with the unique 'ripple effects' of same-day discharge [3].
  • Patients' preoperative expectations of their recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA) can be modified by preoperative educational classes [4].
  • Maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust [5].
  • Underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class during a surgical mission trip [6].
  • A pilot randomized controlled trial will evaluate the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement [7].
  • Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to femoroacetabular impingement (FAI) when compared with the use of CT imaging alone [8].
  • Preoperative video counseling significantly decreased opioid consumption within the first week after total knee arthroplasty [9].

Classification

  • Preoperative opioid education shows some indication of favourable outcomes following elective hand surgery, though the number of studies were small, evidence quality was poor, and data were limited [1].
  • A formal preoperative educational program can help to lower a patient's length of stay following hip or knee arthroplasty [2].
  • Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with same-day discharge [3].
  • Patients' preoperative expectations of their recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA) can be modified by preoperative educational classes [4].
  • Maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust [5].
  • Underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class during a surgical mission trip [6].
  • A pilot randomized controlled trial will evaluate the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement [7].
  • Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to femoroacetabular impingement (FAI) when compared with the use of CT imaging alone [8].
  • Preoperative video counseling significantly decreased opioid consumption within the first week after total knee arthroplasty [9].

Clinical Presentation

  • Preoperative opioid education shows some indication of favourable outcomes following elective hand surgery, though the number of studies were small, evidence quality was poor, and data were limited [1].
  • A formal preoperative educational program can help to lower a patient's length of stay following hip or knee arthroplasty [2].
  • Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with same-day discharge [3].
  • Patients' preoperative expectations of their recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA) can be modified by preoperative educational classes [4].
  • Maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust [5].
  • Underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class during a surgical mission trip [6].
  • A pilot randomized controlled trial will evaluate the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement [7].
  • Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to femoroacetabular impingement (FAI) when compared with the use of CT imaging alone [8].
  • Preoperative video counseling significantly decreased opioid consumption within the first week after total knee arthroplasty [9].

Investigations

  • Preoperative opioid education shows some indication of favourable outcomes following elective hand surgery, though the number of studies were small, evidence quality was poor, and data were limited [1].
  • A formal preoperative educational program can help to lower a patient's length of stay following hip or knee arthroplasty [2].
  • Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with same-day discharge [3].
  • Patients' preoperative expectations of their recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA) can be modified by preoperative educational classes [4].
  • Maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust [5].
  • Underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class during a surgical mission trip [6].
  • A pilot randomized controlled trial is evaluating the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement [7].
  • Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to femoroacetabular impingement (FAI) when compared with the use of CT imaging alone [8].
  • Preoperative video counseling significantly decreased opioid consumption within the first week after total knee arthroplasty [9].

Treatment

  • Preoperative opioid education shows some indication of favourable outcomes following elective hand surgery, though the number of studies were small, evidence quality was poor, and data were limited [1].
  • A formal preoperative educational program can help to lower a patient's length of stay following hip or knee arthroplasty [2].
  • Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with same-day discharge [3].
  • Patients' preoperative expectations of their recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA) can be modified by preoperative educational classes [4].
  • Maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust [5].
  • Underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class during a surgical mission trip [6].
  • A pilot randomized controlled trial will evaluate the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement [7].
  • Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to femoroacetabular impingement (FAI) when compared with the use of CT imaging alone [8].
  • Preoperative video counseling significantly decreased opioid consumption within the first week after total knee arthroplasty [9].

Complications

  • Preoperative opioid education showed some indication of favourable outcomes, though the number of studies was small, evidence quality was poor, and data were limited [1].
  • A formal preoperative educational program can help lower a patient's length of stay following hip or knee arthroplasty [2].
  • Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with same-day discharge [3].
  • Patients' preoperative expectations of recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA) can be modified by preoperative educational classes [4].
  • Maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust [5].
  • Underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class during a surgical mission trip [6].
  • A pilot randomized controlled trial is evaluating the feasibility and satisfaction of the PREPS program for individuals undergoing shoulder replacement [7].
  • Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction regarding femoroacetabular impingement (FAI) when compared with the use of CT imaging alone [8].
  • Preoperative video counseling significantly decreased opioid consumption within the first week after total knee arthroplasty [9].

Recovery

  • Preoperative opioid education shows some indication of favourable outcomes following elective hand surgery, though the number of studies was small, evidence quality was poor, and data were limited [1].
  • A formal preoperative educational program can help lower a patient's length of stay following hip or knee arthroplasty [2].
  • Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with same-day discharge [3].
  • Patients' preoperative expectations of their recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA) can be modified by preoperative educational classes [4].
  • Maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust [5].
  • Underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class during a surgical mission trip [6].
  • A pilot randomized controlled trial will evaluate the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement [7].
  • Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to femoroacetabular impingement (FAI) when compared with the use of CT imaging alone [8].
  • Preoperative video counseling significantly decreased opioid consumption within the first week after total knee arthroplasty [9].

Key Evidence

  • [L1] There was some indication of favourable outcomes following preoperative opioid education; however, the number of studies were small, the evidence quality was poor, and data were limited. (10.1177/17589983241301449)
  • [L3] A formal preoperative educational program can indeed help to lower a patient's length of stay. (10.1016/j.arth.2009.03.012)
  • [L5] Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with the unique 'ripple effects' of same-day discharge. (10.1016/j.arth.2019.01.001)
  • [L1] Patients' preoperative expectations of their recovery from THA or TKA can be modified by preoperative educational classes. (10.1007/s11999-007-0052-z)
  • [L5] The author emphasizes that maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust. (10.2106/jbjs.24.01274)
  • [L4] On this surgical mission trip, underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class. (10.1016/j.arth.2020.04.084)
  • [L2] This pilot randomized controlled trial will evaluate the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement. (10.1177/17589983251345393)
  • [L2] Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to FAI when compared with the use of CT imaging alone. (10.1177/2325967118794645)
  • [L1] This study found significantly decreased opioid consumption within the first week after TKA in patients who received preoperative video counseling. (10.1016/j.arth.2024.02.027)

References

[1] The effect of preoperative interventions on postoperative outcomes following elective hand surgery: A systematic review. Hand Therapy. 2024. DOI: 10.1177/17589983241301449 [2] Patient Education Before Hip or Knee Arthroplasty Lowers Length of Stay. The Journal of Arthroplasty. 2010. DOI: 10.1016/j.arth.2009.03.012 [3] Considerations for Office and Staff Protocols for Outpatient Joint Replacement. The Journal of Arthroplasty. 2019. DOI: 10.1016/j.arth.2019.01.001 [4] Randomized Trials to Modify Patients' Preoperative Expectations of Hip and Knee Arthroplasties. Clinical Orthopaedics & Related Research. 2008. DOI: 10.1007/s11999-007-0052-z [5] What’s Important: Treat the Patient Instead of the Disease. Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.24.01274 [6] Preoperative Patient Education Class During an Orthopedic Mission Trip: Effects on Knowledge, Anxiety, and Informed Consent. The Journal of Arthroplasty. 2020. DOI: 10.1016/j.arth.2020.04.084 [7] Preoperative rehabilitation and education program for surgery (PREPS): A pilot randomized control trial protocol. Hand Therapy. 2025. DOI: 10.1177/17589983251345393 [8] Patient-Specific 3-Dimensional Modeling and Its Use for Preoperative Counseling of Patients Undergoing Hip Arthroscopy. Orthopaedic Journal of Sports Medicine. 2018. DOI: 10.1177/2325967118794645 [9] The Efficacy of Preoperative Video-Based Opioid Counseling on Postoperative Opioid Consumption After Total Knee Arthroplasty: A Prospective Randomized Controlled Trial. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2024.02.027

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c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

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