Building resilience and reversing frailty: a randomised controlled trial of a primary care intervention for older adults.

Background: There is a need for effective primary care interventions that help older people combat frailty and build resilience.

Objective: To study the effectiveness of an optimised exercise and dietary protein intervention.

Design: Multicentre, randomised-controlled, parallel-arm trial.

Protocol for a randomised controlled trial of a primary care intervention to Reverse Frailty and Enhance Resilience through Exercise and dietary protein Education (REFEREE) in community-dwelling adults aged 65 and over.

Resistance exercises and dietary protein have been shown to reverse frailty, yet they are not commonly offered in clinical practice. We aim to measure changes in health outcomes, including physical frailty status (SHARE-FI), clinical frailty status (CFS) and muscle mass, as a result of an optimised exercise and dietary intervention versus usual care in a primary care (PC) setting. The intervention has been derived from our systematic review and meta-analysis findings and optimised through patient and public involvement and multidisciplinary team input.

Femoral offset found not to affect metal ion levels in metal-on-metal total hip arthroplasty.

Background: Failure to restore femoral offset in metal on polyethylene total hip arthroplasty (THA) causes polyethylene wear and aseptic loosening. To our knowledge, no study to date has investigated the relationship between femoral offset and wear in metal-on-metal (MOM) THA.

Aims: In this study, we investigated the relationship between femoral offset and wear by measuring circulating metal ion levels in MOM THA.