What Happens on the Day — An Hour-by-Hour Guide
Part of The Joint Replacement Guide — Phase 4: The Operation · Article 27 of 42 · Hip & Knee
Key Points
- Knowing roughly what to expect on the day itself helps reduce anxiety and lets you plan practically.
- You will meet several members of the team before your operation, each confirming different aspects of your care.
- Modern practice means most patients are helped to sit up, and often stand, on the same day as their operation.
- Exact timings and routines vary between hospitals — this is a general guide, and your own pre-assessment information takes priority.
Before Admission
You’ll usually be given specific instructions in advance about fasting (not eating or drinking for a set period beforehand), which medications to take or pause on the day, and what to bring with you. Following these instructions precisely matters for your safety, particularly around fasting and anaesthesia.
Admission and Preparation
On arrival, you’ll be checked in and settled into a ward bed or admission area. A nurse will confirm your details, check your observations (blood pressure, pulse, temperature), and go through some final checks. Your surgeon will usually visit to confirm the operation and mark the correct site — this is a deliberate safety step, not an oversight on their part, and is part of the WHO Surgical Safety Checklist process discussed earlier in this guide. Your anaesthetist will also visit to discuss your anaesthetic plan and answer any final questions.
Going to Theatre
You’ll be walked or wheeled to the theatre area, where the final WHO checklist steps take place — confirming your identity, the operation, and any allergies one last time before anaesthesia begins. Depending on the anaesthetic plan agreed with you, this is either where you’ll be put to sleep (general anaesthesia) or where your spinal anaesthetic and any nerve block will be given, as discussed in the earlier article on anaesthetic options.
During Surgery
The operation itself typically takes around one to two hours, though this varies depending on the complexity of your case and which joint is being replaced; your total time away from the ward, including anaesthetic preparation and initial recovery, will be longer than the operation itself.
Recovery Room and Return to the Ward
After surgery, you’ll spend time in a recovery area where you’re closely monitored as the anaesthetic wears off, before being transferred back to the ward once you’re stable. Pain relief will be actively managed throughout this period, using the multimodal approach discussed earlier, combining nerve blocks, regular scheduled painkillers, and additional medication as needed.
Later the Same Day
In line with modern Enhanced Recovery After Surgery principles, covered in detail in the next phase of this guide, most patients are helped to sit out of bed, and often to stand and take a few assisted steps, on the same day as their surgery, once they are alert and comfortable enough to do so safely. Physiotherapy and nursing staff will guide and support you through this first mobilisation.
In More Depth
Same-day mobilisation is a relatively recent and significant shift in practice, reflecting a broad body of evidence that earlier movement reduces the risk of complications such as blood clots and chest infections, and is associated with faster overall recovery — a philosophy explored more fully in the dedicated article on Enhanced Recovery After Surgery that follows in the next phase of this guide. Individual hospital protocols and exact routines do vary, so the information given to you specifically at your own pre-assessment appointment should always take priority over this general overview.
This article is general information and does not replace individual clinical advice. Please follow the specific instructions given to you by your own hospital and team.
Sources
- ERAS Society — Enhanced Recovery After Surgery guidelines
- World Health Organization — Surgical Safety Checklist
- NHS.uk — planning for surgery and hospital admission resources
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