Grant: Travel Awards - Institute Community Support

Osteoarthritis is a leading cause of pain and functional limitation leading to reduced independence and quality of life. Total hip replacement is a successful and cost-effective intervention to relieve pain and improve functioning of osteoarthritis patients, however, frailer older adults are at risk of poor outcomes after surgery. Thus, optimizing the health status and physical functioning in this group could help frailer patients achieve better outcomes after hip replacement surgery. We aim to examine: 1) the feasibility of implementing a multi-component frailty intervention (including exercise, vitamin D, protein and medication optimization) compared to usual care in older adults undergoing hip replacement surgery; and 2) the effectiveness of this multi-component frailty intervention in improving patient experience (quality of life, pain reduction, enhanced mobility) and reducing post-operative healthcare utilization including post-surgical complications, length of hospital stay, readmission to hospital and emergency room visits. Participants undergoing hip replacement surgery will be recruited from the Regional Joint Assessment Program in Hamilton, Ontario, if they are 60 years of age or older, pre-frail or frail, and have an expected surgery wait time between 3 and 10 months. Recruited participants will be assigned randomly to the intervention or to standard care. This is the first study to examine the feasibility and effectiveness of a multi-component frailty intervention in pre-frail or frail older adults undergoing hip replacement. It will inform the planning and design of a larger trial to examine the effectiveness of such a strategy and whether targeting frailer patients prior to surgery improves both the patient experience and results in a reduction in health care spending.