Intervention reporting in prehabilitation trials for total hip or knee arthroplasty: A methodological review

Introduction Prehabilitation is the process of enhancing an individual’s functional capacity to better tolerate upcoming stressors such as total hip arthroplasty (THA) or total knee arthroplasty (TKA). Its clinical implementation, however, depends on complete intervention reporting. This review evaluated the completeness of reporting of THA and TKA prehabilitation interventions using the Template for Intervention Description and Replication (TIDieR) checklist and examined changes in reporting quality over time. Methods MEDLINE, EMBASE, CENTRAL, and Google Scholar were searched from inception to May 3, 2024, to identify randomized controlled trials or trial protocols reporting prehabilitation interventions for adults undergoing THA or TKA. Results From 1278 unique search results, 191 full-text studies were assessed for eligibility, and 84 studies met inclusion criteria (n=54 TKA, n=15 THA, n=15 TKA/THA). Prehabilitation intervention modalities reported across studies included exercise (n=51), multimodal programs (n=14), behavioural (n=6), nutritional supplementation or weight loss (n=3), and other (n=10). The mean (standard deviation) TIDieR score was 8.1 (1.6), indicating moderate reporting quality. The proportion of studies reporting each item completely were as follows: name (100%), rationale (100%), materials (67%), procedures (90%), providers (25%), mode of delivery (82%), location (74%), dose and duration (88%), tailoring (35%), modifications (5%), planned adherence (37%), and actual adherence (38%). Reporting quality was similar before and after publication of TIDieR in 2014. Discussion By systematically evaluating reporting quality using the TIDieR checklist, this review identifies the intervention components most often underreported and provides a benchmark to guide future trial design and reporting.