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General Orthopaedics

A Prospective Assessment of Sleep Status in Patients Undergoing Total Knee Arthroplasty

International Society for Technology in Arthroplasty (ISTA)



Abstract

Introduction:

Sleep disturbance is the one of major complaints associated with knee osteoarthritis, and sleep status is one factor that influences quality of life. The present study was designed to assess sleep status in patients undergoing total knee arthroplasty and to identify factors affecting sleep patterns.

Methods:

We performed a prospective study of 112 patients undergoing total knee arthroplasty from June 2011 to February 2012. Data including demographic characteristics (age, gender, BMI, VAS pain scale score, SF 36, level of education, and psychologic comorbidities) and sleep profiles (Nottingham Health Profile – 0 to 100, with 0 indicating good sleep status; Sleep Satisfaction Scale – 0 to 10, with 10 indicating full satisfaction) was collected before and after (six days, two weeks, three months, and six months) total knee arthroplasty.

Results:

There were 11 male and 101 female patients with an average age of 69.3 years (range: 49 to 85 years). The Nottingham Health Profile sleep scores were 30.3, 36.4, 21.0 and 16.7 before and two weeks, three months and six months after surgery, respectively. The corresponding sleep satisfaction scores were 6.6, 7.3, 7.3 and 7.7, respectively. A post-hoc analysis showed that the Nottingham Health Profile and sleep satisfaction scale scores had improved by three and six months after surgery, respectively. Patients with good sleep patterns six months after surgery did not differ from those with poor sleep patterns in terms of demographic characteristics, but a difference was detected in the preoperative sleep profiles between the two groups. Patients with good sleep patterns six months after surgery had better sleep profiles. Additionally, those undergoing unilateral TKA showed significantly better sleep patterns six months after surgery than those undergoing bilateral TKA.

Conclusion:

These findings demonstrate that total knee arthroplasty improved sleep quality in patients with osteoarthritis. Sleep quality improvements were observed three months after surgery, and patients' sleep satisfaction increased six months after surgery. We also found that those with good sleep patterns preoperatively had better sleep patterns six months following surgery compared to those with poor preoperative sleep patterns. Patients undergoing unilateral TKA had a better sleep status than those undergoing bilateral TKA.


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