What tests are done before a knee replacement?

Tests on the knee

The diagnosis is mainly clinical and radiological. Dr. Gelber examines the range of movement, alignment, ligament stability, the kneecap and the hip, because hip arthritis can mimic knee pain. Standing X-rays from the front and side, plus a kneecap view, show the pattern and severity of arthritis. A long-leg X-ray may be taken to measure alignment for planning.

An MRI is generally not needed when X-rays show clear arthritis. It may be used if the X-ray picture does not match the symptoms, or to check whether arthritis is confined to one compartment when a partial replacement is being considered.

Blood and urine tests

• Full blood count to check for anaemia
• Kidney and liver function, which affect medication choices
• Blood sugar and HbA1c, particularly in people with diabetes
• Clotting tests in people on blood thinners or with bleeding problems
• Blood group, in case transfusion is needed
• Urine test to rule out an infection
• Screening swabs for bacteria such as MRSA, depending on hospital protocol

Heart, lungs and anaesthetic review

An ECG is usually done, especially for patients over a certain age or with heart conditions. A chest X-ray, an echocardiogram or a cardiology opinion may be added depending on your history. The anaesthetist reviews the results and discusses spinal or general anaesthesia and pain control with you.

Other checks that matter

Your teeth and skin should be free of infection before surgery, since infections can spread to a new joint. Any wounds, ulcers or skin conditions on the leg are checked. Your list of medicines and supplements is reviewed, and some, such as blood thinners and certain diabetes tablets, may need adjusting.

How this works at Aman Hospital

Tests are usually arranged in the weeks before surgery so that any problem can be corrected in time. If something needs treatment first, the date is moved rather than taking an unnecessary risk.