ArticleBMC musculoskeletal disorders2025
Pre-operative education and prehabilitation provision for patients undergoing hip and knee replacement: a national survey of current NHS practice.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Perceived factors shaping preoperative self-preparation among older patients undergoing total knee arthroplasty: a qualitative study.BMJ open · 2026Article
- 'Waiting poorly' for hip and knee arthroplasty - unmet needs and lack of support while waiting for surgery : findings of the multicentre WAIT-DATA study.Bone & joint open · 2026Article
- Six-session non-operative exercise program yields sustained benefits for up to 18 months in end-stage knee osteoarthritis: a retrospective cohort study.Clinical rheumatology · 2026Article
- Multimodal prehabilitation for frail older adults having hip or knee replacement: a qualitative exploratory study of barriers and facilitators.BMC musculoskeletal disorders · 2026Article
- Using a Co-Designed Digital Self-Management Program to Prepare Patients for Hip or Knee Replacement Surgery: Pragmatic Pilot Study.JMIR rehabilitation and assistive technologies · 2026Article
- Slow march to surgery: using the COM-B model to explore the lived experience of individuals with knee osteoarthritis, awaiting joint replacement surgery.Rheumatology advances in practice · 2026Article
- Feasibility of scaling-up an evidence-based physical activity behaviour change intervention into routine ambulatory hospital care: a retrospective implementation evaluation using the RE-AIM framework.BMC public health · 2025Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundOver 215,000 total hip replacements (THRs) and total knee replacements (TKRs) take place annually in the UK. Joint replacement has the longest waiting times of elective surgical treatments, with some patients waiting up to two years for surgery in the NHS. Pre-operative education and support interventions could improve both pre-operative health and optimise post-operative outcomes. However, current pre-operative NHS service provision is heterogenous and poorly described. This study aimed to describe the current services and care provided to patients on NHS waiting lists for THR and TKR.
methodsA link to a national online survey about pre-operative education and prehabilitation was sent to relevant healthcare professionals involved in the pre-operative care of patients waiting for THR or TKR surgery at a sample of high-, mid- and low-volume NHS hospitals in the UK. Participants were asked questions about what pre-operative education and pre-habilitation services were offered at their hospital, and any barriers or facilitators to delivering care. Frequency statistics were used to describe categorical data and free-text data were coded into categories.
resultsResponses were received from 29 UK hospitals across seven regions. Pre-operative education was provided to patients at 28 hospitals, primarily at single session talks supplemented with booklets. Prehabilitation was provided to patients waiting for TKR at 17 hospitals and to patients waiting for THR at 14 hospitals. It comprised strengthening exercises and advice with written information. Three hospital respondents did not know if prehabilitation was provided before TKR and four hospitals before THR. Barriers to service provision include funding, staffing, facilities, and lack of awareness/evidence on how best to deliver services.
conclusionsPrehabilitation services are not provided for all patients waiting for arthroplasty. Future work is needed to design and evaluate prehabilitation resources to optimise pre-operative health and improve patient outcomes after TKR and THR.
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