Preoperative examination A comprehensive understanding of the health status of the elderly patient, detailed inquiries about the patient’s past medical history, medication history, especially the history of thrombosis. All routine auxiliary examinations should also be performed, including three major routine tests, determination of blood sugar, liver function, kidney function, thrombosis routine, electrocardiogram and so on. This will enable early detection, early prevention and early treatment of some existing and potential diseases in the physical condition, improve the success rate of surgery and reduce the occurrence of postoperative complications. For example, the incidence of diabetes in the elderly is higher than that of other people. If the preoperative period can be detected in time and the blood glucose is well controlled, the blood glucose value should be maintained in a certain range 5 days before the operation, so as to avoid the incision not healing due to high blood glucose after the operation, and the preoperative blood glucose check also provides the basis for the postoperative blood glucose control. Blood glucose was controlled at 7.2 to 10 mmol/L and urine glucose (+ to -). If the patient is on anticoagulant medication (e.g., taking aspirin), it must be discontinued for more than 6 days before undergoing surgery. Patients with hypertension should have their blood pressure reduced to less than 150 mm Hg before surgery. Patients who have had “heart attacks” or heart stents, etc., should wait until they have been stable for 6 months before surgery. Kreuzncher Diakonie Hospital, German National Rheumatology Center