Preoperative Patient Preparation for Total Knee Arthroplasty

The perioperative treatment of patients who undergo total knee arthroplasty is commonly discussed and the focus of many researchers. Typically, protocols and pathways are developed by surgeons and hospitals to standardize the care of, improve the outcomes of, and minimize complications in these patients. Intraoperative and postoperative total knee arthroplasty protocols have been well documented in the literature and are the subject of a substantial number of peer-reviewed studies. The preoperative treatment and optimization of these patients is a topic that has been somewhat neglected; however, recent studies have deemed the topic extremely relevant. The preoperative treatment of patients who undergo total knee arthroplasty includes a thorough medical evaluation, an infection prevention plan, and blood and pain management strategies. The perioperative optimization of these patients may lead to improved patient selection, reduced complications, and improved patient satisfaction. Preoperative patient optimization is important given the trend toward pay-for-performance and bundled payment models and has led to a drastic reduction in blood transfusions, improved patient safety, lower postoperative pain scores, and a reduction in the overall rate of infection.