Older woman exercising at home to improve her fitness before surgery

Hip and knee replacements are common operations for patients with osteoarthritis. It is a major operation with a long recovery period. One-third to one-half of people waiting for hip or knee replacements are frail (physical vulnerable e.g., lower strength and less mobile) and may experience more complications and longer hospital stay.

Evidence suggests that an improved diet with extra protein and pre-operative exercise may lead to fewer post-operative complications and faster recovery. However, no studies have looked at pre-operative protein and exercise in frail individuals undergoing hip or knee replacement in the NHS. ‌

In the Joint PREP intervention, patients are provided with a personalised home exercise programme and daily protein supplements for 12 weeks before their joint replacement surgery. We want to see if the Joint PREP intervention can improve recovery from surgery in frail older people having hip or knee replacement. First, however, we need to see if people are willing to do this by running a small study, called a ‘feasibility study’. If they are, we will design a larger randomised trial to test whether it improves recovery.