To facilitate safer operations, we provided a preoperative rehabilitation and educational program covering exercise and diet for obese patients with severe osteoarthritis. Participants totaled 11 patients of which 9 had metabolic syndrome. Exercises included the usual muscle strengthening ones, a range of motion exercise and 30 minutes of walking within parallel bars four times a day. This was combined with a diet program. The averaged results showed that body weight changed from 73.5kg to 64.7kg, body mass index from 31 to 27, and waist size from 106 to 94cm. Blood tests indicated that the average triglyceride level changed from 219 to 127mg/dL and fasting blood glucose from 146 to 94 mg/dL. Total steps walked per day changed from 2840 to 6953 and SF36 improved in all items. Significant improvements were noted in all items tested. Our program provided an effective rehabilitation for patients before operation by reducing patient' symptoms due to metabolic syndrome, reducing leg pain and body weight - while increasing activity, and improving quality of life, while simultaneously decreasing the risk of postoperative venous thromboembolism.