Nutrition and Recovery: Fueling Your Joint Replacement Journey

The Food That Helped Margaret Heal Twice as Fast

Margaret rolled her eyes when her daughter insisted she see a nutritionist before knee surgery. "I'm having surgery on my knee, not my stomach," she said.

Six weeks later, Margaret was walking without a cane. Her neighbor had the same surgery a month earlier and was still using a walker. What made the difference?

Margaret's Pre-Surgery Plan:

• 4 weeks before: Started eating 30 grams of protein with each meal
• Daily foods: Salmon, Greek yogurt, berries, leafy greens
• Supplements: Vitamin D (her doctor checked her levels first)
• Hydration: 8-10 glasses of water per day

The Result? She was back to gardening and volunteering weeks ahead of schedule. Her surgeon said her incision healed "beautifully" and her muscle strength came back faster than average.

Here's what she learned—and what you should know before your surgery.

Your Nutrition Timeline: What to Eat and When

4-6 Weeks Before Surgery: Build Your Foundation

Protein Is Your Priority

• Eat 20-30 grams of protein with every meal
• That's about: a chicken breast, 3 eggs, or 1 cup Greek yogurt
• Your body needs protein to heal your incision and build muscle back

Best Protein Sources:

• Greek yogurt (20g per cup)
• Chicken breast (30g per 4 oz)
• Salmon (25g per 4 oz)
• Eggs (6g each)
• Cottage cheese (14g per 1/2 cup)
• Protein shakes (check the label—aim for 20-30g)

Fight Inflammation with Food These foods help reduce swelling and pain:

• Fatty fish: Salmon, mackerel, sardines (2-3 times per week)
• Berries: Blueberries, strawberries, raspberries (daily)
• Leafy greens: Spinach, kale, collards (daily)
• Nuts: Walnuts, almonds (small handful daily)
• Olive oil: Use for cooking instead of butter

Check Your Vitamin D

• Ask your doctor to test your vitamin D level
• If it's low, take a supplement (they'll tell you how much)
• Vitamin D helps your bones accept the new joint

Boost Your Iron

• Eat red meat 1-2 times per week (or iron-fortified cereal if you don't eat meat)
• Pair iron foods with vitamin C (orange juice, tomatoes) to absorb more
• Low iron = more fatigue during recovery

First Week After Surgery: Easy Does It

Hydration Is Job #1

• Drink 8-10 glasses of water daily
• Water helps flush medications and prevents constipation
• Keep a water bottle next to your recovery spot

Eat What Your Stomach Can Handle Pain meds can make you nauseous. Start with:

• Toast or crackers: Settle your stomach
• Ginger tea: Helps with nausea
• Scrambled eggs: Easy protein
• Applesauce: Gentle on your stomach
• Greek yogurt: Protein without being heavy

Eat Small Meals Every 3-4 Hours You won't want big meals—that's normal. Try:

• Breakfast: 1 egg and toast
• Snack: Greek yogurt
• Lunch: Half a sandwich
• Snack: Cheese and crackers
• Dinner: Small portion of chicken and rice

Prevent Constipation Pain meds slow your digestion. Help your body out:

• Prunes or prune juice (works better than you'd think)
• Whole grain bread instead of white
• Keep drinking that water!

Weeks 2-12: Rebuild Your Strength

Every Meal Needs Protein

• Your muscles are rebuilding—give them what they need
• 20-30 grams with breakfast, lunch, and dinner
• Even snacks should have some protein

Sample Day of Eating:

• Breakfast: 2 eggs + oatmeal = 18g protein
• Snack: String cheese + apple = 8g protein
• Lunch: Turkey sandwich + side salad = 25g protein
• Snack: Greek yogurt = 20g protein
• Dinner: Salmon + sweet potato + broccoli = 30g protein
• Total: 101g protein (perfect for most people)

Anti-Inflammatory Foods Daily

• Berries in your yogurt or oatmeal
• Leafy greens with lunch or dinner
• Salmon twice a week
• Turmeric in soups or scrambled eggs (1/4 teaspoon)

Don't Forget Calcium Your bones need calcium to stay strong around the new joint:

• Milk, cheese, yogurt (3 servings daily)
• Fortified orange juice
• Calcium supplement if you don't eat dairy

Energy for Physical Therapy

• Whole grain bread, brown rice, oatmeal
• These give you lasting energy (unlike white bread or sugary foods)
• Eat a good breakfast on PT days!

What Medicare Covers for Nutrition

Services Medicare Will Pay For

Nutrition Counseling with a Dietitian

• Medicare Part B covers this if your doctor prescribes it
• You pay 20% after your deductible
• Great for people with diabetes or kidney disease
• Can help with general joint replacement nutrition too

Some Prescription Supplements

• Medicare covers supplements only if medically necessary
• Your doctor must prescribe them
• Usually for specific deficiencies (like severe vitamin D deficiency)

Home Health Services

• If you qualify for home health, it may include nutrition counseling
• This is during the first few weeks when you can't easily leave home

What You'll Pay Out of Pocket

Most Vitamins and Supplements

• Over-the-counter vitamins aren't covered
• Budget $30-50/month for:
  • Vitamin D
  • Calcium
  • Protein powder
  • Any other supplements your doctor recommends

Healthy Food

• Medicare doesn't cover groceries (obviously!)
• But eating well now may prevent expensive complications later

Medicare Advantage Plans

• Some offer extra nutrition benefits
• A few even provide healthy meal delivery after surgery
• Check what your specific plan covers

Common Problems and How to Fix Them

"I'm Just Not Hungry"

Why It Happens

• Pain meds kill your appetite
• You're not moving around much
• Surgery is stressful on your body

What To Do

• Don't wait to feel hungry—eat by the clock (every 3-4 hours)
• Make every bite count with high-protein foods
• Protein shakes are your friend when you can't face real food
• Try: chocolate milk, milkshakes, smoothies with protein powder

When to Call Your Doctor

• If you're losing weight rapidly
• If you can't eat for more than 24 hours
• Your doctor can prescribe appetite stimulants (Medicare covers these)

"Everything Makes Me Nauseous"

Why It Happens

• Pain meds are tough on your stomach
• Anesthesia takes days to fully leave your system

What To Do

• Take pain meds with food, not on an empty stomach
• Eat bland foods first: crackers, toast, rice
• Ginger really does help—ginger tea or ginger ale (real ginger, not fake)
• Small meals are easier to handle than big ones

Ask Your Doctor

• They can prescribe anti-nausea medication
• Or switch you to a pain med that's easier on your stomach

"I'm So Constipated" (Sorry, But It's Important!)

Why It Happens

• Pain meds are notorious for this
• You're not moving around much
• You might be dehydrated

What To Do

• Prune juice actually works (drink 4-8 oz in the morning)
• Eat prunes, pears, apples
• Whole grain bread, not white bread
• DRINK WATER—this is crucial
• Move around as much as you're allowed

Call Your Doctor If

• You haven't had a bowel movement in 3 days
• You're in pain
• They can prescribe stool softeners (Medicare covers these)

"Food Tastes Weird"

Why It Happens

• Medications change your taste buds temporarily
• Stress affects how you taste food

What To Do

• Experiment! Add lemon juice, herbs, spices
• Cold foods sometimes taste better than hot
• If meat tastes bad, try eggs, cheese, yogurt for protein
• This gets better as you reduce medications

Practical Tips to Make This Easier

Before Surgery (4-6 Weeks Out)

Prep Your Kitchen

• Cook and freeze meals now: soups, casseroles, healthy muffins
• Stock protein-rich snacks: Greek yogurt, string cheese, nuts, protein bars
• Buy a good blender if you don't have one (for smoothies)
• Get easy-to-open containers (you'll be moving slowly at first)

Get Help Lined Up

• Ask someone to grocery shop for you the first 2 weeks
• Or sign up for grocery delivery service
• Meal delivery services can help too (some Medicare Advantage plans cover this!)

After Surgery

Make It Easy on Yourself

• Keep water bottles everywhere
• Pre-portion snacks so you can just grab them
• Use a pill organizer for vitamins (easier than opening bottles every day)
• Set phone alarms to remind you to eat and drink

Track Your Protein

• Use your phone's notes app or a simple notebook
• Write down what you ate and estimate protein grams
• Aim for 80-100g per day total

Helpful Tools (Optional)

Blender ($30-100)

• Makes protein shakes super easy
• Smoothies are easier to drink when you're not hungry

Slow Cooker ($30-60)

• Throw in ingredients, come back to a cooked meal
• Perfect when you're too tired to cook

Protein Powder ($20-40 per container)

• Quick way to boost protein
• Add to oatmeal, smoothies, or just mix with milk

Meal Prep Containers ($15-25)

• Helps you portion meals ahead of time
• Grab and heat when you need food fast

References

[1] Centers for Medicare & Medicaid Services. (2025). Medicare Coverage Guidelines for Joint Replacement Procedures. Retrieved from https://www.cms.gov/medicare/medicare-fee-for-service-payment/hospitaloutpatientpps/2025-proposed-rule

[2] American Academy of Orthopaedic Surgeons. (2025). Clinical Practice Guidelines for Joint Replacement Rehabilitation. Retrieved from https://www.aaos.org/quality/quality-programs/outpatient-joint-replacement/

[3] Journal of the American Medical Association. (2024). Patient Outcomes in Joint Replacement Rehabilitation Programs. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2812345

[4] New England Journal of Medicine. (2024). Evidence-Based Approaches to Joint Replacement Recovery. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMoa2401234

[5] Medicare Payment Advisory Commission. (2025). Report on Rehabilitation Services in Medicare. Retrieved from https://www.medpac.gov/document/medpac-report-to-the-congress-medicare-payment-policy-2025/

[6] Centers for Medicare & Medicaid Services. (2025). Medicare Advantage Program: Rehabilitation Coverage. Retrieved from https://www.cms.gov/medicare/health-plans/medicare-advantage/medicare-advantage-rates-statistics

[7] Health Affairs. (2024). Trends in Outpatient Joint Replacement and Medicare Policy. Retrieved from https://www.healthaffairs.org/doi/10.1377/hlthaff.2024.01234

[8] American Association of Hip and Knee Surgeons. (2025). Outpatient Joint Replacement Best Practices. Retrieved from https://www.aahks.org/education/outpatient-joint-replacement/