Outcome measures in prehabilitation interventions for total hip and knee arthroplasty: A scoping review

ObjectiveThis scoping review aimed to map outcome measures collected in randomised controlled trials investigating prehabilitation interventions in total hip and knee arthroplasty, and timepoints of collection.Data sourcesA systematic search of MEDLINE, EMBASE, Web of Science, Cochrane, and CINAHL was conducted.MethodsThis review followed the Joanna Briggs Institute Scoping Review methodology. Outcome domains, concepts of interest and assessment tools were characterised using the International Society for Pharmacoeconomics and Outcomes Research Framework, and timepoints for data collection were extracted.ResultsNinety-two trials (published between June 2001 and March 2025) were included. Most delivered unimodal prehabilitation, with exercise the most common intervention (n = 37). The review identified 36 outcome concepts measured with 219 assessment tools. Patient-reported outcomes were collected in 92% of trials (n = 85), and was the most heterogenous domain with 102 assessment tools. Performance-based outcomes, most commonly muscle strength, were collected in 66% of trials (n = 61) and utilised 47 different tools. Observer-reported outcomes were reported in 60% of trials (n = 55), with healthcare utilisation (e.g. hospital length of stay) the most common concept. Clinician-reported outcomes were reported in 48% of trials (n = 44) and most frequently included post-operative complications. Biomarker outcomes were rare (n = 7, 8%). Timing of outcome collection varied, with just over half the trials collecting both a pre-operative and post-operative timepoint.ConclusionThis review identified significant variability in outcome measures collected in prehabilitation trials for total hip and knee arthroplasty, highlighting the need for a core set of assessments to facilitate consistent reporting and robust meta-analyses of prehabilitation efficacy.