Ali Alipourian1, Negin Farhadian2, Ehsan Zereshki2, Habibollah Khazaie3. 1. Sleep Disorders Research Center, Health Institute, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran. 2. Research Center for Environmental Determinants of Health (RCEDH), School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. 3. Sleep Disorders Research Center, Health Institute, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran. hakhazaie@gmail.com.
Abstract
BACKGROUND: Total knee arthroplasty (TKA) is an accepted, effective treatment to restore function, relieve pain, and improve the quality of life in patients with advanced osteoarthritis. One complication of this major surgery is impaired sleep quality. This study examines the quality of sleep in patients undergoing TKA before and after their operation. METHODS: All relevant records were obtained using a systematic search in three online databases: PubMed, Scopus, and Cochrane library. Out of the 177 records retrieved, only eight matched the inclusion criteria. Due to the lack of sufficient data, only four studies entered the meta-analysis. Values reported for sleep quality based on the Pittsburgh Sleep Quality Index (PSQI) were extracted from patient records before and after surgery. A random-effect model was used to analyze the data. RESULTS: The results of the meta-analysis show a significant difference in the improvement of sleep quality after surgery at two time points of 4-6 weeks after surgery from the preoperative baseline (SMD - 0.16; 95% CI - 1.05 to 0.74; P = 0.0) and 3-6 months after surgery from the preoperative baseline (SMD - 0.92; 95% CI - 1.61 to - 0.24; P = 0.0). CONCLUSIONS: The results show that TKA generally improves the patients' sleep quality. Although some studies reported disrupted sleep quality in periods close to the surgery (especially in the early days after surgery), all studies have reported improved sleep quality in the late postoperative intervals.
BACKGROUND: Total knee arthroplasty (TKA) is an accepted, effective treatment to restore function, relieve pain, and improve the quality of life in patients with advanced osteoarthritis. One complication of this major surgery is impaired sleep quality. This study examines the quality of sleep in patients undergoing TKA before and after their operation. METHODS: All relevant records were obtained using a systematic search in three online databases: PubMed, Scopus, and Cochrane library. Out of the 177 records retrieved, only eight matched the inclusion criteria. Due to the lack of sufficient data, only four studies entered the meta-analysis. Values reported for sleep quality based on the Pittsburgh Sleep Quality Index (PSQI) were extracted from patient records before and after surgery. A random-effect model was used to analyze the data. RESULTS: The results of the meta-analysis show a significant difference in the improvement of sleep quality after surgery at two time points of 4-6 weeks after surgery from the preoperative baseline (SMD - 0.16; 95% CI - 1.05 to 0.74; P = 0.0) and 3-6 months after surgery from the preoperative baseline (SMD - 0.92; 95% CI - 1.61 to - 0.24; P = 0.0). CONCLUSIONS: The results show that TKA generally improves the patients' sleep quality. Although some studies reported disrupted sleep quality in periods close to the surgery (especially in the early days after surgery), all studies have reported improved sleep quality in the late postoperative intervals.
Entities:
Keywords:
Meta-analysis; Pittsburgh Sleep Quality Index (PSQI); Systematic review; Total knee arthroplasty (TKA)
Authors: Marie Carmen Valenza; Gerad Valenza; Emilio González-Jiménez; Ana Isabel De-la-Llave-Rincón; Manuel Arroyo-Morales; César Fernández-de-Las-Peñas Journal: Am J Phys Med Rehabil Date: 2012-07 Impact factor: 2.159