Multimodal prehabilitation before elective hip or knee replacement for frail older adults
Multimodal Prehabilitation of Frail Patients 70 Years and Older Undergoing Elective Knee or Hip Replacement: A Pilot Randomized Controlled Trial
This program will test whether a tailored multimodal prehabilitation package can help frail adults aged 70 and older who are waiting at least two months for elective hip or knee replacement do better around the time of surgery.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 50 (estimated) |
| Ages | 70 Years and up |
| Sex | All |
| Sponsor | University of Iceland Academic / other |
| Locations | 1 site (Reykjavik) |
| Trial ID | NCT07465159 on ClinicalTrials.gov |
What this trial studies
This pilot randomized controlled trial at Landspítali–University Hospital will screen patients aged 70+ scheduled for elective hip or knee arthroplasty using PRISMA-7, the Clock Drawing Test, and the Timed Up and Go; those positive on any screen will be randomized to multimodal prehabilitation or standard care. The intervention includes a comprehensive geriatric assessment, medication review, and individually tailored physiotherapy plus other targeted supports delivered before surgery. Patients already in frequent physiotherapy, those undergoing redo procedures, or those who do not proceed to planned surgery are excluded. The trial aims to establish feasibility and gather preliminary outcome data to inform a larger study.
Who should consider this trial
Good fit: Ideal candidates are adults aged 70 or older scheduled for elective hip or knee replacement at Landspítali with at least a two-month wait time who screen positive on one of the frailty screening tools and are willing to be randomized and give consent.
Not a fit: Patients who screen negative for frailty, those already receiving active physiotherapy (more than one visit per month), those undergoing redo prosthesis surgery, or those who do not undergo the planned operation are unlikely to benefit from this program.
Why it matters
Potential benefit: If successful, the program could reduce surgical risk and improve recovery and function after hip or knee replacement for frail older adults.
How similar studies have performed: Previous prehabilitation programs have shown promise for improving surgical outcomes, but randomized evidence specifically in frail orthopedic patients is limited, so this approach remains relatively novel in that group.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients aged 70 years or older assigned to undergo hip/knee replacement at Landspítali University Hospital. * Inclusion will be offered to patients who have previously presented at the outpatient orthopedic department and been scheduled for an elective (with a waiting period ≥2 months before surgery) hip/knee replacement. * Patients who are willing to participate and sign informed consent and are willing to be randomized to the control or intervention arm. Exclusion Criteria: * Patients who screen negative for all frailty tools will be excluded from the study. * Patients who are already in active physiotherapy, meeting with a physiotherapist \>1 every month, will also be excluded. * In addition, those who do not undergo planned surgery, are undergoing redo hip/knee prosthesis replacement will be excluded
Where this trial is running
Reykjavik
- Landspitali University hospital — Reykjavik, Iceland (Recruiting)
Study contacts
- Study coordinator: Martin I Sigurdsson, MD, PhD
- Email: mingi@hi.is
- Phone: +354-824-8282
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.