Preoperative Optimization Before Total Hip or Knee Replacement Surgery (PrOpE)

February 9, 2026 updated by: Medical University Innsbruck

Preoperative Optimization Before Total Hip or Knee Replacement Surgery - a Controlled, Randomized, Single-blind Study

Preoperative Optimisation prior to Hip and Knee Arthroplasty (PrOpE) Many patients scheduled for planned hip or knee replacement surgery have health conditions that may affect recovery, such as reduced physical fitness, nutritional problems, multiple medications, or increased stress and anxiety. These factors can increase the risk of complications and delay recovery after surgery.

The PrOpE study examines whether a structured preparation programme before surgery, known as preoperative optimization or prehabilitation, can be safely implemented and may support recovery after hip or knee replacement.

Aim of the study The main aim is to assess the feasibility of a comprehensive preoperative optimisation programme and to explore its potential effects on recovery and health outcomes. The results will help improve future care for patients undergoing major orthopaedic surgery.

Who can participate? Adult patients scheduled for elective total hip or knee replacement surgery who are classified as ASA >2, aged between 18 and 99 years old and without a severe cognitive impairment. Participation is voluntary.

Study design

A total of 180 participants will be included and randomly assigned to one of two groups:

• Standard Care Group: Participants receive usual medical care before and after surgery.

• Intervention Group:

In addition to standard care, participants receive an individualised preparation programme over several weeks before surgery. This programme may include:

  • Personalised physical exercise
  • Nutritional assessment and advice
  • Support for stress, pain, and mental well-being
  • Review of regular medications Some elements may be delivered at home or via telemedicine, depending on individual needs.

What information is collected? The study evaluates recovery after surgery, including complications, length of hospital stay, physical function, quality of life, and use of health care services. Questionnaires, physical tests, and blood samples are used to better understand health status before and after surgery.

Risks and benefits The study involves low additional risk. All measures are adapted to individual abilities and supervised by trained professionals. The main burden is the additional time required for participation. Participants in the optimisation group may benefit from improved preparation for surgery. The study also contributes to improving care for future patients.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Preoperative Optimisation prior to Hip and Knee Arthroplasty (PrOpE) Many patients scheduled for planned hip or knee replacement surgery have health conditions that may affect recovery, such as reduced physical fitness, nutritional problems, multiple medications, or increased stress and anxiety. These factors can increase the risk of complications and delay recovery after surgery.

The PrOpE study examines whether a structured preparation programme before surgery, known as preoperative optimization or prehabilitation, can be safely implemented and may support recovery after hip or knee replacement.

Aim of the study The main aim is to assess the feasibility of a comprehensive preoperative optimisation programme and to explore its potential effects on recovery and health outcomes. The results will help improve future care for patients undergoing major orthopaedic surgery.

Who can participate? Adult patients scheduled for elective total hip or knee replacement surgery who are classified as ASA >2, aged between 18 and 99 years old and without a severe cognitive impairment. Participation is voluntary.

Study design

A total of 180 participants will be included and randomly assigned to one of two groups:

• Standard Care Group: Participants receive usual medical care before and after surgery.

• Intervention Group:

In addition to standard care, participants receive an individualised preparation programme over several weeks before surgery. This programme may include:

  • Personalised physical exercise
  • Nutritional assessment and advice
  • Support for stress, pain, and mental well-being
  • Review of regular medications Some elements may be delivered at home or via telemedicine, depending on individual needs.

What information is collected? The study evaluates recovery after surgery, including complications, length of hospital stay, physical function, quality of life, and use of health care services. Questionnaires, physical tests, and blood samples are used to better understand health status before and after surgery.

Risks and benefits The study involves low additional risk. All measures are adapted to individual abilities and supervised by trained professionals. The main burden is the additional time required for participation. Participants in the optimisation group may benefit from improved preparation for surgery. The study also contributes to improving care for future patients.

Study Type

Interventional

Enrollment (Estimated)

180

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Austria
    • Tyrol
      • Innsbruck, Tyrol, Austria, 6020
        • Recruiting
        • Medical University Innsbruck
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • American Society of Anesthesiologists (ASA) physical status classification ≥ 3
  • Age between 18 and 99 years
  • All sexes
  • Elective total hip or knee replacement with a waiting period of ≥ 8 weeks between surgical indication and surgery
  • Ability to understand the nature, content, and procedures of the study and to provide written informed consent
  • Written informed consent obtained prior to any study-related procedure

Exclusion Criteria:

  • Pregnancy or active breastfeeding
  • Severe trauma or major blood loss within 14 days prior to enrollment
  • Participation in another pharmacological or interventional clinical study
  • Contraindications to physical training
  • Pre-existing diagnosis of moderate to severe dementia

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Standard Care Group
Participants receive usual medical care before and after surgery.
Experimental: Intervention Group

In addition to standard care, participants receive an individualised preparation programme over several weeks before surgery. This programme may include:

  • Personalised physical exercise
  • Nutritional assessment and advice
  • Support for stress, pain, and mental well-being
  • Review of regular medications
Other: Prehabilitation
  • Personalised physical exercise
  • Nutritional assessment and advice
  • Support for stress, pain, and mental well-being
  • Review of regular medications Some elements may be delivered at home or via telemedicine, depending on individual needs.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Length of hospital stay
Time Frame: From enrollment to the postoperative discharge from the hospital (9 to 25 weeks).
Length of hospital stay (intensive care unit, recovery room, observation unit, general ward; date of discharge readiness and actual discharge)
From enrollment to the postoperative discharge from the hospital (9 to 25 weeks).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Medical University Innsbruck

Investigators

  • Principal Investigator: Barbara Sinner, MD, MBA, Medical University Innsbruck

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

February 5, 2026

Primary Completion (Estimated)

February 5, 2034

Study Completion (Estimated)

February 5, 2034

Study Registration Dates

First Submitted

January 30, 2026

First Submitted That Met QC Criteria

January 30, 2026

First Posted (Actual)

February 6, 2026

Study Record Updates

Last Update Posted (Actual)

February 11, 2026

Last Update Submitted That Met QC Criteria

February 9, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • EK-Nr. 1193/2025

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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