Journal Article

Tailored outpatient physiotherapy rehabilitation versus standardised usual care physiotherapy after revision total hip replacement: protocol for a randomised controlled feasibility trial

Hannink, Erin, Toye, Francine, Morris, Alana, Barker, Karen L, Stokes, Elizabeth A, Fordham, Beth, Gerry, Stephen, Palmer, Antony J

2026

Overview

BackgroundTotal hip arthroplasty (THA) is a highly effective procedure for improving pain and function in patients with advanced joint degeneration; however, revision surgery may be required because of complications or implant wear. Revision THA (rTHA) has a higher in-hospital mortality rate, longer hospital length of stay, are at higher risk of re-revision surgery and have worse physical and mental health outcome measures compared with primary THAs. The introduction of specialist revision hubs also means that patients frequently travel further for surgery. No specific guidelines have been established for rehabilitation after rTHA, leading to large variations in practice and potentially inadequate provision. We hypothesise that delivering a tailored physiotherapy intervention will improve and sustain greater functional outcomes and health-related quality of life compared with standard protocols currently in place. The aim of this study is to determine the feasibility and explore the acceptability of a trial investigating the effectiveness of a tailored physiotherapy intervention after rTHA.Methods and analysisMulticentre, parallel two-arm feasibility randomised controlled trial with an embedded qualitative study. A total of 60 participants will be recruited from at least four UK NHS secondary care hospitals and randomly allocated (1:1 ratio) to either the tailored physiotherapy rehabilitation (THRIVE) programme or a standardised usual care arm. Eligible adults will be undergoing a single or final stage rTHA and participating in outpatient physiotherapy. Feasibility outcomes include recruitment rate, retention rate, adherence rate, intervention fidelity, outcome measure completion and acceptability of the intervention. Research assessments consisting of patient-reported and performance-based measures will occur preoperatively (baseline), with follow-ups at 4 and 8 months postoperatively. Feasibility data will be analysed using descriptive statistics. The embedded qualitative study will include trial participants and physiotherapists from the THRIVE arm to explore their experience of the trial and understand measures to improve the delivery of a future trial.Ethics and disseminationThe study has received ethical approval (West of Scotland REC 25/WS/0080), and all participants will provide informed consent. It will assess trial feasibility while exploring operational and safety challenges, including recruitment barriers and the potential value of a hub-and-spoke model for delivering physiotherapy. Findings will be disseminated through trial registry reporting, peer-reviewed open-access publication, conference presentations and participant summaries, with reporting aligned to CONSORT guidelines for pilot and feasibility trials.Trial registration number ISRCTN10649335.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Ambulatory Care - methods / Arthroplasty, Replacement, Hip - rehabilitation / Consent / Feasibility Studies / Female / Gait / Hip / Hospitals / Humans / Medical research / Multicenter Studies as Topic / Objectives / Participation / Patients / Physical therapy / Physical Therapy Modalities / Protocol / Qualitative research / Quality of Life / Randomized Controlled Trial / Randomized Controlled Trials as Topic / Rehabilitation / Rehabilitation Medicine / Reoperation - rehabilitation / Research Design / Retention / Surgery / Treatment Outcome / United Kingdom