Preparing for Surgery


OPA’s personal surgery schedulers work directly with patients and all parties involved to coordinate and schedule the various components of your surgery — and to help alleviate any concerns or uncertainty you may have.

The first step is getting preauthorization from your insurance company…

Understand the pre-authorization & billing process

  • OPA will contact your insurance company to obtain prior authorization for surgeon and surgery assistant services only. You are responsible for confirming benefits for anesthesia and surgery facility services directly with your insurance company.
  • If you have private insurance, the OPA surgical care team will provide you with a surgery cost estimate at the time of the appointment. Once verified, OPA will call you to discuss your insurance coverage and benefits, your estimated financial responsibility and any pre-surgery deposits that may be required.
  • You will receive separate bills from separate companies for services related to your surgery:
    • OPA surgeon and assistant surgeon
    • Surgery facility
    • Anesthesiologist
    • Radiology
    • Neuromonitoring during some spine surgeries

We advice our patients to also:

1. Contact your insurance carrier for your benefits and any additional information you may need from them.

2. Contact your surgery facility to discuss their financial expectations. 

Pre-Op Appointments

Medical clearances, signed consents and hospital or surgery center pre-registration and pre-admission are required for all surgeries and involve the following sequential steps. Your OPA surgery scheduler will work with you, your surgeon and others to schedule these visits and the initial post-operative follow up visits for you to help make your experience as effective, easy, timely and efficient as possible. They will also help you understand all pre-operative instructions.

1. History & Physical Clearance Appointment

After your surgery date is determined, a medical clearance appointment will be scheduled for you either with your primary care physician or an OPA orthopedic provider. The purpose of this appointment is to determine whether you are physically able to tolerate surgery and achieve the best possible outcome. This appointment will include a thorough physical exam and may also include lab work, chest x-ray and E.K.G. studies. A written medical clearance based on this work is required by the hospitals, surgery centers, anesthesiologists and OPA surgeons before surgery can be performed.

Please note that insurance companies may not cover the cost of this appointment depending on the terms and conditions of your policy, and may result in additional charges to you when performed outside of OPA’s office.

2. Other Medical Clearance Appointments as Needed

Depending on your medical condition, other special surgery clearance appointments may be needed. These include clearances related to cardiac, pulmonary, diabetic and other conditions.

3. Pre-operative Visit with OPA Surgeon

One of your most important pre-operative visits will be with your OPA surgeon. The purpose of this visit is to review the results from your history and physical appointment(s) and subsequent diagnostic studies, review the surgery plan including pre and post-operative instructions, discuss the risks and possibilities of complications with your surgery and sign the necessary surgery consent forms. This is also an excellent time to make sure all your questions have been answered before your surgery.

Please carefully think through and write down your questions, concerns and expectations to help you prepare for this visit. After this visit, you will receive your Surgery Orders Packet. Among other vital documents, this packet includes written pre-operative and post-operative instructions from your surgeon.

4. Hospital or Surgery Center Pre-registration & Pre-admission

After your visit with your OPA surgeon, we ask that all patients immediately take their Surgery Order Packet directly to the hospital or surgery center where their surgery will be performed. Upon arrival, patients check in with the Admitting Department to pre-register and complete pre-admission paperwork for their surgery procedure. This process typically takes about two hours to complete.

5. The Night Before Surgery

Please read and carefully follow all pre-operative instructions from the surgeon. For example, to avoid complications with anesthesia, surgery patients absolutely must not eat or drink anything, chew gum or continue any medications after midnight. If this is not followed, the surgery will be cancelled and rescheduled for another day.

If patients have prescribed medications, other than pain relief medications, which must be taken in the morning, please check with the anesthesia department associated with the hospital or surgery center to confirm that those medications are approved to be taken after midnight before surgery. Approved medications should be taken as early as possible with a minimal amount of water.

If you have any questions or concerns before any of your appointments or before your surgery date, please contact your surgery scheduler immediately. If your surgeon’s scheduler is not available, please contact any member of the surgeon’s care team.

Pre-Op Patient Requirements

Please follow these instructions carefully so your surgical team can proceed with the surgery. Download in PDF             

Week Prior to Surgery

  • Arrange for a responsible adult to drive you home from surgery. Under no circumstances may patients drive themselves home from the surgery center/hospital.
  • If general anesthesia is used, you will also need to have a responsible adult stay with you for 24 hours.
  • Do not make any other plans for the day of your surgery. Surgery times are always subject to change. (Your ride should also reserve the whole day.)

Day Before Surgery

  • Visit the facility where your surgery is scheduled to preregister and meet with a pre-op nurse.
  • Do not eat or drink anything after midnight the night before your procedure. If you do, OPA will be forced to cancel your surgery. (This is very important; the intake of food and liquid affects anesthesia.)

Day of Surgery

  • Remember not to eat or drink anything! In the morning, you may take all approved medications, but with only a small amount of water.
  • Bathe or shower prior to your surgery — and do not use lotions or oils after doing so. Remove all makeup, nail polish, hairpieces and body jewelry. Note: Joint replacement surgeries may require specific washes or wipes.
  • Wear loose comfortable clothing large enough to accommodate any necessary bandages.
  • Be sure to bring…
    • A case for your contact lenses, glasses and/or dentures.
    • Your government-issued picture ID card
    • Insurance cards
    • Your Surgery Order Packet
  • Leave all valuables at home, including jewelry, cellular phones, cash, etc.
  • Arrive at the surgery facility 2 hours prior to your scheduled surgery time to allow for pre-operative preparations.

If you have any questions or concerns before any of your appointments or before your surgery date, please contact your surgery scheduler immediately.  Click on the “Surgery Schedulers” tab of our Phone DirectoryIf your surgeon’s scheduler is not available, please contact any surgery scheduler in the office. 

Hip & Knee Replacements: Pre-op Exercises

It is important to begin to exercise as soon as you know you are having surgery. Exercising will help to strengthen your arm, thigh, and hip muscles to help you recover more quickly after surgery. Cardiovascular conditioning (steady exercise for 10-20 minutes) will greatly help, too.

Goals & Cautions

Start slowly and if exercise causes pain, fatigue or shortness of breath, slow down or stop, and your surgeon’s office if you’re concerned. Increase time or repetitions as your endurance and condition will allow. Work up to a 20-minute program. You should be able to carry on a conversation while exercising, but feel as though you are working fairly hard.

General (Cardiovascular) Activities

  • Walk, walk, walk!
  • Swim laps, walk or perform exercises in a (preferable warm) pool.
  • Bike. If balance or the weather is challenging for you, use a stationary bike.


Specific Exercises

For all exercises, generally start with 10 repetitions and work up to 30 as you are able.


Ankle Pumps: Point and flex your ankles.


Chair Push Ups: Put your hands on the arms of the chair and push down in order to lift your body up.


Gluteal sets: Sitting or lying in bed, squeeze your buttocks together without using your thigh muscles. Hold for 5 seconds.


Heel slides: Lie down on your bed with your legs straight out.
Keeping your feet on the bed, slide the heel of your surgical leg toward your buttock, bending your knee.


Hip abduction/adduction: Lie down on your back with your legs straight out.
Slide your heel out to the side and back in (without lifting leg off bed).


Long Arc Quads: While sitting in a chair, slowly raise your foot
until your knee is completely straight. Hold for 5 seconds.


Mini-squats: Stand in front of a countertop or other sturdy surface you can hold on to for balance and support.
Very carefully, slightly bend your knees like you are going to squat down. Do not go down too far; stop if it becomes painful.
Do not let your knees go past your toes. Hold 5 seconds, stand, repeat.


Quad sets: Lie down on your back with your surgical leg straight out.
Push the back of your knee into the bed, tightening up the top of your thigh. Hold for 5 seconds.


Seated Hamstring Stretch:
Sit on firm couch or bed with one leg extended, other leg on floor.
Keeping your back slightly arched, gently lean forward.
You should feel a gentle pull in the back of your thigh. Hold for 20 seconds, relax, repeat.
Perform 1 set of 4 repetitions, twice a day.


Short Arc Quads: Lie in your bed with a small pillow/roll under both knees.
Gently lift your heel off of the bed, straightening your knee.
Do NOT raise thigh off of the pillow. Hold for 5 seconds.


Straight Leg Raises: Lie down on your back with your good knee bent and foot flat on the ground.
Lift the other leg up while keeping the knee straight.
Raise your leg no higher than the height of the other leg’s knee.


The OPA team includes Alaska’s leading specialists and offers some of the latest, most advanced treatment procedures available today.

OPA treats a wide variety of conditions and offers comprehensive treatment options — including many non-surgical solutions, minimally invasive arthroscopies (repairs), and total joint replacement.

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