Multimodal Prehabilitation of Frail Patients 70 Years and Older Undergoing Elective Knee or Hip Replacement: A Pilot Randomized Controlled Trial

What this Trial Is About

Frailty is a common condition in older adults that reduces physical resilience and increases risks during surgery, especially for those undergoing hip or knee replacement. Researchers are evaluating a multimodal prehabilitation program to see if it can improve outcomes for frail patients aged 70 years and older who are scheduled for elective hip or knee arthroplasty. This pilot randomized controlled trial aims to provide early evidence on the program's feasibility and potential benefits. The study compares two groups: one receiving a multimodal prehabilitation program starting at least 2 months before surgery, and a control group receiving standard care. The prehabilitation includes a comprehensive geriatric assessment, medication review, tailored physiotherapy based on the Otago Exercise Programme, and nutritional counseling if malnutrition risk is detected. The control group follows usual preoperative routines, including physiotherapy guidance, nursing consultations, anesthetic evaluations, and medication adjustments, typically 1 to 4 weeks before surgery. Participants will be monitored from enrollment through surgery and up to 180 days afterward. Researchers will assess recruitment and retention rates, adherence to exercise and nutrition plans, physical performance using balance and mobility tests, postoperative complications, patient-reported joint health and quality of life, hospital stay length, discharge location, falls, readmissions, and mortality. This comprehensive evaluation aims to inform the design of larger studies and improve care for frail arthroplasty patients.

Multimodal Prehabilitation of Frail Patients Undergoing Elective Knee or Hip Replacement