Published on: 8th October 2025

Preparing for hip or knee replacement isn’t just about booking an operation, it’s about getting stronger, managing pain, and giving yourself the best chance of a quicker, smoother recovery. 

That’s why the Therapies Department at RNOH joined a national James Lind Alliance (JLA) Priority Setting Partnership, led by Robert Gordon University, to ask the people who know best - patients, carers and clinicians - what questions about prehabilitation should drive future research.

Prehabilitation helps slow deterioration while waiting for surgery, reduces pain, improves mobility and can speed up recovery after the operation. It can also protect mental health by restoring a sense of control and purpose during a stressful time. But what works, for whom, and how to deliver it equitably across the NHS isn’t yet fully clear. This project set out to change that by putting lived experience at the centre of the research agenda.

A diverse steering group, including people with lived experience, surgeons, physiotherapists, occupational therapists and health psychologists, led a rigorous, inclusive process to gather and rank questions from across the country. 

The result is a clear, patient-led Top 10 list of research priorities for prehabilitation in hip and knee replacement. These priorities will guide researchers, funders and NHS teams to focus on the issues that make the biggest difference to real people.
 

Top 10 research priorities for prehabilitation:

  1. What are the best types of prehabilitation to help people cope with pain and improve strength before their surgery?

  2. How can prehabilitation programmes be made accessible and beneficial for everyone, including people with other health conditions or from different backgrounds?

  3. What role does mental health and psychological support play in recovery, and how should it be provided?

  4. How can NHS and community services work together to provide joined-up support before surgery?

  5. What’s the best way to personalise prehabilitation, so exercises, diet, and advice match each patient’s needs and abilities?

  6. How can we ensure people get the right information and support while waiting for their operation?

  7. What training do staff and carers need to support patients doing prehabilitation at home?

  8. How effective is digital or remote support (like apps, videos, or online classes) for people preparing for surgery?

  9. What service improvements would make it easier to deliver prehabilitation to everyone who needs it?

  10. How can we help people stay motivated and continue prehabilitation as they prepare for their operation?
     

These priorities align with the NHS 10-Year Health Plan focus on prevention and better outcomes. They cover the issues that most affect people’s quality of life while they wait for hip and knee replacement, from managing pain and finding the right exercise programme to ensuring support is fair and accessible for everyone, especially those at greatest risk of poorer outcomes. They tackle the real challenges of long waiting lists and aim to make prehabilitation practical and effective for day-to-day life.

By putting patients, carers and clinicians at the centre of the process, the top 10 reflect the questions that matter most to people living with pain and the hope of regaining normal life. These priorities will help direct research and services toward solutions that make a meaningful difference before, during and after surgery.

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