Frailty Intervention in Postoperative Hip Fracture Inpatients

Launched by ROYAL COLLEGE OF SURGEONS, IRELAND · Jun 16, 2025

Keywords

ClinConnect Summary

This clinical trial is looking at whether a combined program of exercise and nutrition can help older adults who have had surgery after breaking their hip. Hip fractures are common in older people and can make it hard to move around, increase the chance of other health problems, and sometimes lead to needing long-term care. Frailty—a condition where someone is weaker and has less ability to do everyday activities—is often seen in these patients and can make recovery harder. This study aims to see if a special program started soon after surgery, which includes strength exercises and nutritional support like protein supplements, is safe and helpful for improving recovery in the hospital setting.

To join the study, participants need to be 65 or older, have a mild to moderate level of frailty, and have recently had surgery for a typical kind of hip fracture caused by a fall or weak bones. They must be medically stable, able to walk before the fracture (with or without some help), and able to safely do some weight-bearing after surgery. People with serious medical conditions, cognitive problems, or other health issues that would make exercise unsafe cannot join. If eligible, participants will take part in an exercise and nutrition program during their hospital stay, designed to be doable and safe, with the goal of helping improve strength and recovery after hip surgery.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Older adults \>/= 65
• • Clinical Frailty Score 4-6 (This includes patients with very mild, mild and moderate frailty. This would be in keeping with literature quoting frailty interventions where patients who are 'pre-frail' and frail are included)
• • Post fragility hip fracture (including subtrochanteric fracture)
• • Post hip fracture surgery (all types including total hip replacement, hemiarthroplasty, IM nailing)
• • Medically stable postoperatively
• • No weightbearing restriction
• • Mobile pre-admission (including aids and max assist of 1 person)
• Exclusion Criteria:
• • Medically unstable (NEWS \>3, unless a higher cutoff is stipulated by the primary medical researcher)
• • Non fragility hip fracture (fracture from non osteoporotic aetiology, pathologic fracture)
• • Hip surgery for other aetiology (prosthetic joint infection, arthritis, implant loosening, avascular necrosis, periprosthetic fracture)
• • Polytrauma
• • Delirium or severe cognitive impairment (as defined by inability to follow instructions and unable to provide informed consent)
• • Pre-existing neurologic or cardiovascular disorders that would affect participation/ compliance with exercise intervention
• • Open hip fracture
• • Other lower limb orthopaedic disorders that affect participation/ compliance with exercise intervention
• • Terminal illness with \</= 6 months to live
• • Active treatment for cancer (systemic chemotherapy or radiotherapy, patients on oral chemotherapeutic agents/ checkpoint inhibitors will be eligible for inclusion)
• • Nursing Home Resident
• • Severe lower limb pain post-op
• • Severe skin issues/ ulcers in non-operated lower limb that would preclude utilisation of ankle weights
• • Swallowing disorders/ difficulty
• • Renal impairment with eGFR \<30
• • Hepatic failure
• • Patients with a dairy/ soy allergy