Enhanced Recovery After Surgery (ERAS)

Total Knee Arthroplasty ERAS

Appointment New Patient Appointment or 214-645-8300


The objectives of our Enhanced Recovery After Surgery (ERAS) programs are to:

  • Make this an optimal surgical experience for you, our patient
  • Incorporate innovative pain medications to improve your postoperative pain control while decreasing your narcotic needs
  • Prevent potential surgical and anesthetic complications
  • Reduce the amount of time you are in the hospital, with the goal of discharging you home after one to two days
  • Decrease the likelihood that you will have to return to the hospital after discharge
  • Return you to a higher level of function and ability than before your surgery

Before Surgery

  • Your surgeon will meet with you to explain surgical plans and set expectations for your surgery.
    • If questions arise, contact your surgeon via MyChart or call the Orthopaedic Clinic: 214-645-3300.
  • You will receive instructions for surgery and medications via a phone call prior to surgery. You might also be scheduled for an appointment in our Pre-Surgical Testing Clinic to meet with our anesthesia team or have bloodwork drawn.
    • We may request testing or records from your other physicians.
    • Call our Pre-Surgical Testing Clinic with any questions: 214-633-4202.
  • Lifestyle modifications:
    • You must stop smoking for one month prior to surgery, and we encourage you to stop consuming alcohol for one month prior to surgery.
    • We encourage you to increase your physical activity prior to surgery as tolerated. You will receive specific instructions during your pre-surgery physical therapy visit regarding exercises to do at home. You will also be asked to attend a joint bootcamp where you will learn more about your surgery, recovery, and the steps to help you along the way.
    • Eat a balanced, healthy diet high in protein and remain hydrated throughout the months leading up to surgery. Your physical strength before surgery is important to recovering well after surgery.
  • Three days before surgery:
    • Apply mupirocin nasal ointment (betadine swabs if you’re allergic to mupirocin). This is done to minimize risk of infection.
  • On the night before surgery:
    • Do not eat solid foods after 11 p.m.
    • Shower with Hibiclens® (which you will receive at your clinic visit).
    • You can drink clear liquids (such as water, Gatorade, or Sprite) until two hours before your surgery start time.
  • On the day of surgery:
    • Shower with Hibiclens®.
    • Drink either a bottle of water or 20 ounces of Gatorade on the way to the hospital, at least two hours before your surgery start time.
    • In the pre-op area, you will receive non-narcotic pain medications (celecoxib and acetaminophen) to reduce your postoperative pain. If you are at high risk for nausea, you might be given medicines before surgery to decrease this risk.
    • Most patients receive a nerve block before surgery. The nerve block uses local anesthetic to decrease your pain after surgery.

During Surgery

  • You will receive either spinal anesthesia or general anesthesia.
    • With either option, you will be comfortable and “sleeping.”
    • Unless you have back problems, blood clotting problems, major heart problems, or are on blood thinners, a spinal would be the preferred option.
  • Your anesthesia team will monitor you very closely during the surgery and will insert additional intravenous (IV) lines if necessary.
  • You will receive multiple medications during surgery to treat pain and nausea.
  • There will be a specific and tailored anesthetic protocol to decrease the stress on your body, improve pain, and accelerate your recovery.

Post-Anesthesia Care Unit (PACU) and After

  • You will wake up in our Post-Anesthesia Care Unit (PACU).
  • Physical and occupational therapy will be an essential part of your recovery. When possible, you will start physical therapy on the same day as your surgery.
  • Beginning on the day of surgery, it will be important for you to get out of bed and walk with help from your nurse or therapist.
  • Unless instructed otherwise by your nurse or surgeon, you should be able to eat a normal diet a few hours after surgery.
  • You will take scheduled non-opioid pain medications during your recovery and have narcotic medications available for breakthrough pain, if necessary.

Important Contact Information

  • Pre-Surgery Testing Clinic: 214-633-4202
  • Orthopaedic Clinic:
    • Dallas location on Inwood Road: 214-645-3300
    • Richardson/Plano location on Waterview Pkwy.: 214-645-4116
  • Anesthesiology website