Deciding to have an endoprosthesis – an artificial joint – is a major step. Whether it's a hip replacement (total hip arthroplasty) or a knee replacement (total knee arthroplasty) , thorough preparation is crucial for the success of the surgery, the speed of recovery, and the longevity of the implant.
This article explains in detail how you can best prepare yourself physically, mentally, and logistically for your endoprosthesis , what prehabilitation means, the nutrition , exercise , medication , and psychological factors – and why it's worthwhile to have the treatment performed ENDOPROTHETICUM Rhein-Main

Many patients underestimate how much their own body and mind can influence the success of surgery. Well-planned preparation for a hip or knee replacement shortens rehabilitation, reduces pain, and lowers the risk of complications.
Measurable benefits can be achieved through targeted measures even just a few weeks before the operation.

• Improved muscle strength and mobility
• More stable circulation and metabolism
• Fewer inflammations and infections
• Faster mobilization after surgery

In this context, modern medicine speaks of "prehabilitation" – that is, targeted training and optimization of the state of health before an operation.

What does prehabilitation mean in the context of hip replacement or knee replacement?

Definition and objective

Prehabilitation is the counterpart to traditional rehabilitation. While rehabilitation takes place after surgery, prehabilitation optimally prepares the body and mind for the upcoming stresses
before the procedure The goal is to strengthen muscles, the cardiovascular system, lungs, and metabolism so that the body regenerates more quickly endoprosthesis

Patients participating in a structured prehabilitation program have, in studies:

• a shorter hospital stay ,
• lower pain levels,
• fewer postoperative complications
  and faster recovery of mobility .

How long should you prepare?

Ideally, preparation begins 4–6 weeks before the planned surgery . During this time, muscles, circulation, nutrition, and mental well-being can be specifically strengthened.
However, even if the date is set at short notice, it is worthwhile to become active even a few days before the operation – every step counts.

Physical preparation for an endoprosthesis

Muscle building and joint mobility

Strong muscles around the affected joint are the most important factor for a smooth healing process. This is especially true for hip replacements (total hip arthroplasty) and knee replacements (total knee arthroplasty): the stronger the surrounding muscles, the better the new joint is guided and stabilized.

Recommended exercises (after consulting a doctor or physiotherapist):

• Leg axis training : Activation of quadriceps and hip abductors
• Balance training : Improving coordination
• Stretching exercises : Maintaining flexibility and preventing muscle shortening
• Breathing exercises : Strengthening the diaphragm for better oxygen supply

Many specialized clinics already offer prehabilitation programs that are individually tailored to the respective endoprosthesis.

Weight and metabolism

Excess weight increases the risk of complications, impaired wound healing, and loosening of the prosthesis .
Therefore, it is recommended to achieve a stable, healthy weight before surgery. Even a 5–10% weight reduction can significantly reduce joint stress.
Patients with diabetes, high blood pressure, or metabolic disorders also benefit from medically supervised adjustments to their medication before the procedure.

Nutrition before surgery

A balanced diet rich in protein, vitamins, and minerals is essential for wound healing and tissue regeneration .
The following are particularly important:

• Protein (fish, legumes, dairy products) for muscle building
• Vitamin C and zinc for the immune system
• Vitamin D and calcium for bone quality

Patients should reduce their alcohol and nicotine consumption as much as possible , as both negatively affect blood flow and healing.

Medical preparation and preliminary examinations

Preoperative diagnostics

Before any endoprosthesis is implanted, a series of medical examinations are conducted to minimize risk and optimally plan the procedure.
These include:

• Blood test (inflammation markers, coagulation, electrolytes)
• ECG and, if necessary, lung function test
• X-ray or MRI for precise surgical planning
• Investigation of chronic diseases such as diabetes or heart problems

An experienced endoprosthetics specialist coordinates these examinations and compares all results with the planned operation.

Medication management

Many medications need to be adjusted before surgery, especially:

• Blood thinners (e.g. ASS, Marcumar, NOACs)
• Diabetes medication
• Blood pressure medication
• Cortisone-containing medications

These adjustments are always made in close consultation with the surgeon . The aim is to minimize the risk of bleeding while simultaneously ensuring a safe cardiovascular situation.

Vaccination status and infection prophylaxis

Complete vaccination , especially against influenza, COVID-19, and pneumococcus, is recommended before joint replacement surgery.
Equally important:

• Check for dental and skin infections (even the smallest inflammations can be sources of bacteria).
• Treatment of chronic infections (e.g., sinuses).

Because: An infection in the body can lead to dangerous prosthesis infections .

Psychological preparation for an endoprosthesis

Mental strength and expectations

Joint replacement surgery triggers anxiety in many patients: pain, anesthesia, and limited mobility. These concerns are perfectly normal – but they can be actively addressed.
A positive attitude and realistic expectations have been proven to improve postoperative outcomes.

Helpful measures:

• Conversations with the surgeon – the better the understanding, the less fear.
• Breathing and relaxation techniques – for stress reduction.
• Contact with former patients – to gain realistic insights into the process.

Informational discussion as an opportunity

The consultation is far more than a mandatory event. It offers an opportunity to openly address all questions – for example, about implant types, durability, anesthesia, pain management, or rehabilitation.
A specialist like Prof. Dr. Karl Philipp Kutzner places great importance on ensuring that patients make their decision with conviction and confidence.

Preparing everyday life and living environment for the endoprosthesis

Preparation for a joint replacement doesn't end in the doctor's office or the training room – it begins at home.
An optimized living environment is crucial for safe and independent mobility after the operation.

Avoid tripping hazards

After hip (total hip arthroplasty) or knee replacement (total knee arthroplasty), balance is often still impaired. Even small obstacles can lead to dangerous falls.
Therefore:

• Remove loose carpets, cables, and small pieces of furniture.
• Ensure good lighting – especially on the way to the bathroom or bedroom.
• Keep passageways clear to allow easy access for people using walking aids.

Patients often report that these simple measures greatly ease everyday life after surgery.

Organize everyday assistance

Prepare your daily routine so that you as independent as possible after your joint replacement surgery . Helpful items include:

• Grabbers and long-handled shoehorns to avoid bending over.
• Elevated toilet seats and shower stools to protect the joint.
• Non-slip mats in the bathroom and shower.
• Comfortable shoes with a firm sole and Velcro closure instead of laces.

These adjustments ensure safety – especially in the first few weeks after a hip or knee replacement .

Help with household chores and social support

Endoprosthesis surgery is physically and logistically demanding. Planning for support early on helps avoid stress.

• Ask family members or friends to help with shopping or cooking.
• Inform your employer about the upcoming procedure and the expected duration of your absence.
• Clarify the organization of the rehabilitation – inpatient or outpatient.

A well-planned daily routine reduces anxiety and speeds up the return to a self-determined life.

Prehabilitation in detail – the training plan before the endoprosthesis

The basic idea of ​​prehabilitation

Prehabilitation means preparing the body for upcoming stresses – with targeted training that improves strength, mobility, and endurance.
This concept is now an integral part of modern endoprosthesis centers, such as the ENDOPROTHETICUM Rhein-Main , where individually tailored programs are developed.

Training focus areas for hip replacement (total hip arthroplasty)

Patients who receive a hip replacement benefit from exercises that strengthen the surrounding muscles:

• Hip abductor training (lateral leg raises)
• Pelvic tilts while lying down to activate the deep trunk muscles
• Mini squats to improve standing stability
• Single-leg standing exercises to improve balance

It is important that the exercises are performed painlessly

Training focus areas for knee replacement (total knee arthroplasty)

For patients with a planned knee replacement , the focus is on:

• Quadriceps strengthening (e.g., leg extensions while seated)
• Leg axis control to stabilize movement
• Mobilization of the kneecap to improve mobility
• Stretching the back of the thigh (hamstring muscles)

Many sufferers benefit from physiotherapy guidance to avoid incorrect postures and overexertion.

Breathing and circulatory training

A well-trained cardiovascular system improves oxygen supply and wound healing.
Recommended activities:

• Daily walks (10–30 minutes)
• Exercise bike training without peak loads
• Breathing exercises for lung ventilation

These measures reduce the risk of thrombosis, infections, and circulatory problems after surgery.

Nutrition and nutrient supply before endoprosthesis

The importance of a protein-rich diet

Protein is the building block for muscles, skin, and connective tissue. Adequate intake is crucial before surgery to prevent muscle atrophy. A
of 1.2–1.5 g of protein per kilogram of body weight is recommended – ideally from lean meat, fish, eggs, legumes, or dairy products.

Those who have difficulty consuming enough protein can use medically recommended protein drinks or shakes .

Vitamins and trace elements

Vitamin D , zinc , vitamin C , and iron a crucial role
in wound healing before surgery can detect any deficiencies. If a deficiency is found, it can usually be corrected within a few weeks – often through a combination of diet and supplements.

Hydration and metabolic balance

Adequate fluid intake (1.5–2 liters daily) stabilizes circulation, blood pressure, and metabolism.
Older patients, in particular, often forget to drink regularly.
Water, unsweetened teas, or diluted fruit juices are ideal . Caffeine and alcohol should be reduced in the weeks leading up to surgery to avoid putting additional strain on the body.

Mental and emotional preparation

Understanding fear – and reducing it effectively.

Many people associate joint replacement surgery (artificial joint replacement) with fear of pain or loss of control. However, modern medicine and specialized clinics now offer a virtually pain-free experience.
Open communication with the surgeon or anesthesiologist helps to alleviate concerns.

Mental preparation can include:

• Breathing techniques or meditation for stress reduction
• Daily relaxation time to promote sleep and regeneration
• Positive visualization : Imagine yourself walking or running pain-free again.

A stable psyche has been proven to promote healing.

Develop realistic expectations

Even with the best hip or knee replacement, the body needs time to adapt.
The goal is freedom from pain and mobility , not necessarily high-performance sports.
Patients who understand this experience their recovery more positively and with greater motivation.

The treating physician should speak transparently about realistic goals – e.g., when climbing stairs will be possible again or when driving will be allowed.

The day before the operation

Final preparations

The last day before the operation is for rest. Plan everything essential:

• your documents, medication, and insurance card ready.
• Leave valuables at home.
• Final personal hygiene and disinfection shower as per doctor's instructions.
• A light meal in the evening and plenty of fluids.

Psychologically helpful: A short walk to strengthen confidence in one's own body.

The day of the surgery itself

On the day of your surgery, it's important to stay calm . The medical team will ensure your safety and comfort.
Before the anesthesia, all steps will be explained again. The procedure then begins – the implantation of a hip or knee replacement (total hip replacement, total knee replacement) usually only takes about one hour.

After the recovery phase, pain therapy and initial mobilization follow. Modern concepts (" fast-track endoprosthetics ") make it possible to be back on your feet just a few hours after the operation.

After the operation: The first days with an endoprosthesis

Early mobilization and first steps

On the day of the procedure, Professor Kutzner and the nursing team will assist you in getting up.
The goal is to quickly activate your circulation, muscles, and joint function .
Early movement significantly reduces the risk of thrombosis, infection, and muscle atrophy.

Pain management

Modern pain therapy now uses multi-stage procedures :

• Local nerve blocks
• Drug combination therapy
• Cold and relaxation techniques

The goal is not complete freedom from pain, but a controllable, functional state that allows movement.

Rehabilitation after endoprosthesis – the way back to movement

The actual surgery is only the beginning. The long-term success of an endoprosthesis depends crucially on rehabilitation . It is the key to mobility, quality of life, and the longevity of the implant.

Early phase – the first few weeks

The first few days after surgery are characterized by gentle mobilization. The goal is to build confidence in the new joint.
The first mobilization takes place on the first or second day after the operation, under the guidance of a physiotherapist .

Early phase goals:

• Restoring the sense of balance
• Muscle activation
• Improvement of joint mobility
• Pain reduction through movement

This requires patience and consistency – every movement, every time you get up, counts.

The forms of rehabilitation

Hospitalization is usually followed by inpatient or outpatient rehabilitation . Both options have advantages and disadvantages that should be decided on an individual basis.

• Inpatient rehabilitation:
  Patients live in a rehabilitation clinic for 2–3 weeks, where therapy sessions take place daily. Ideal for elderly people or those living alone.
• Outpatient rehabilitation:
  Patients sleep at home and attend a specialized facility during the day. Particularly suitable for younger, mobile people with family support.

ENDOPROTHETICUM Rhein-Main supports its patients in choosing the optimal form of rehabilitation – with ENDOPROtherapeuticum, follow-up treatment in the form of ENDO-Reha is also available in Mainz.

Building phase – targeted muscle training

In the following weeks, the focus will shift to
strength and coordination training Targeted exercises will help to stabilize the joint and normalize its function.

Recommended focus areas:

• Muscle building (thighs, buttocks, torso)
• Gait training with and without walking aids
• Exercise in water (aquagymnastics)
• Stretching exercises to keep the joint capsule supple

Many patients experience for the first time during this phase what pain-free movement feels like – a motivating experience that accelerates the healing process.

Long-term care of the endoprosthesis

Regular follow-up care

An endoprosthesis is a high-tech medical device – and should be monitored accordingly.
Regular follow-up examinations with a specialist can be crucial to:

• to check the fit and stability of the prosthesis
• to detect wear and tear or loosening
• and adjust the individual exercise program if necessary.
  

Long-term exercise recommendations

A hip or knee replacement is not an obstacle to activity – quite the opposite.
Regular exercise keeps muscles, bones and the circulatory system healthy.

Recommended sports:

• Cycling (ergometer and outdoors)
• Nordic walking
• Swimming and aqua jogging
• Slow hiking or golf

Sports involving jumping, stopping or turning movements, such as tennis, football or jogging on hard surfaces, are less recommended.

Nutrition and weight control after surgery

Even after successful implantation, body weight remains a crucial factor.
Every extra kilogram increases the pressure on the implant. A balanced diet therefore protects not only your heart and circulatory system, but also your prosthesis.

Recommended:

• A high-protein, high-fiber diet
• Avoid highly processed foods
• Regular fluid intake
• Conscious control of body weight

Common mistakes in preparation for an endoprosthesis

Error 1: Activation too late

Many patients only start exercising shortly before their surgery. However, the earlier you start, the better.
Even simple exercises several weeks before the procedure can significantly improve the outcome.

Mistake 2: Fear-induced protective posture

Avoiding all movement out of fear of pain weakens the muscles and impairs blood circulation.
Excessive rest before surgery significantly prolongs the rehabilitation phase afterward.

Mistake 3: Unbalanced diet

A one-sided or low-calorie diet can impair wound healing. Adequate protein intake is particularly important – without it, the body regenerates more slowly.

Error 4: Unclear medication coordination

Stopping blood thinners, diabetes medication, or blood pressure medication on your own can be risky.
All changes must be discussed with your doctor to avoid complications.

Mistake 5: Lack of mental preparation

Many underestimate the importance of mental stability.
Fear, insecurity, and negative expectations can significantly impact the healing process.
Talking, visualization, and relaxation help build confidence in one's own strength.

Tips for family members – how you can provide support

Good preparation concerns not only the patient, but also their family and friends. Relatives can make a crucial contribution to the success of the treatment.

Practical tips:

• Encourage movement – ​​but without pressure.
• Ensure a safe environment at home.
• Accompany them to doctor's appointments or rehabilitation.
• Offer emotional support and patience.

A positive, supportive atmosphere is the most important motivating factor for many affected individuals.

The role of specialized endoprosthesis centers

Why specialization is crucial

Not every clinic has the same experience in endoprosthetics. Studies show that
specialized centers with a high volume of cases and standardized procedures achieve better results, fewer complications, and higher patient satisfaction.

The ENDOPROTHETICUM Rhein-Main – excellence in endoprosthetics

The ENDOPROTHETICUM Rhein-Main, under the direction of Prof. Dr. Karl Philipp Kutzner, is considered one of the leading centers for hip and knee endoprosthetics in the Rhine-Main region .
Here, the focus is on the individual – from the initial consultation and prehabilitation to rehabilitation.

The interdisciplinary team places the highest value on:

• individual therapy planning,
• state-of-the-art surgical procedures,
• joint-friendly techniques and
• personal follow-up care.

Patients benefit from comprehensive preparation, highly precise surgery and holistic aftercare – all under one roof.

Conclusion – The best results come with the right preparation

An endoprosthesis (artificial joint) is not a life sentence, but an opportunity for a new quality of life.
With targeted preparation – physical, mental, and organizational – you can significantly contribute to ensuring that your hip replacement (total hip arthroplasty) or knee replacement (total knee arthroplasty) functions optimally and lasts reliably for many years.

In summary:

• Start exercising and training your muscles early.
• Pay attention to a balanced diet and a stable metabolic state.
• Prepare your living environment for the postoperative phase.
• Use psychological strategies to cope with anxiety.
• Choose a specialized center such as the ENDOPROTHETICUM Rhein-Main.

Recommendation

If you would like a personal consultation or to optimally prepare for your operation,
make an appointment at ENDOPROTHETICUM Rhein-Main with
Prof. Dr. Karl Philipp Kutzner – one of the most experienced endoprosthetics specialists in Germany.

📍 Location: Mainz
🌐 Website: www.endoprotheticum.de

Here you will receive individual preparation, excellent surgical care and holistic aftercare that will secure your new quality of life.