Perioperative Mindfulness Training Does Not Improve Sleep Quality in Patients Undergoing Total Knee Arthroplasty

IF 2.1 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2026-02-01 Epub Date: 2025-12-15 DOI:10.1016/j.artd.2025.101918

Jessica L.H. Phillips MD , Makenna R. Hemmerle MS , Roseann M. Johnson BS , Hayley E. Ennis MD , Jason J. Jennings MD, DPT

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引用次数: 0

Abstract

Background

Sleep quality declines in the immediate postoperative period following total knee arthroplasty (TKA). No prior study has prospectively analyzed the impact of mindfulness meditation (MM) on sleep quality following TKA. The purpose of this study was to determine whether MM administered in conjunction with TKA results in any improvement in Pittsburgh Sleep Quality Index (PSQI) at 2, 6, or 12 weeks postoperatively.

Methods

Patients undergoing primary unilateral TKA were prospectively enrolled and randomized into 3 cohorts. The perioperative MM cohort received MM at the preoperative visit, the day preceding surgery, 3 days postoperatively, and 2 weeks postoperatively. The preoperative MM group only received MM at the preoperative visit. Controls received no MM. MM consisted of a video of 2 licensed professional psychologists guiding viewers through a 15-minute MM. Demographic data were collected and questionnaires completed at 2, 6, and 12 weeks postoperatively. Patients were excluded on the basis of prior alcohol/drug dependence and inability to present to in-person visits. An a priori analysis required 75 patients per cohort to achieve 80% power.

Results

Two hundred eighty-two patients were enrolled and randomized to 3 groups: control (n = 94), preoperative MM (n = 94), and perioperative MM (n = 94). There were no differences between cohorts in age (P = .24), sex (P = .77), body mass index (P = .18), American Society of Anesthesiologists (P = .17), or length of stay (P = .18). No differences between cohorts in preoperative PSQI scores were noted (8.4 ± 4.1 control, 7.9 ± 3.8 preoperative MM, 7.8 ± 4.3 perioperative MM; P = .58). Two weeks postoperatively, there remained no PSQI differences between groups (10.7 ± 4.3 control, 10.8 ± 4.4 preoperative MM, 9.9 ± 4.4 perioperative MM; P = .33). This persisted at 6 weeks (10.1 ± 4.2 control, 10.0 ± 3.9 preoperative MM, 9.5 ± 4.4 perioperative MM; P = .62). At 12 weeks, PSQI returned to preoperative levels and there remained no difference among cohorts (8.7 ± 4.4 control, 8.3 ± 4.2 preoperative MM, 7.8 ± 4.1 perioperative MM; P = .264).

Conclusions

Mindfulness training did not improve postoperative sleep quality at any time point following TKA. Further studies are warranted, as improving sleep quality may enhance TKA rehabilitation.

Level of Evidence

Therapeutic Level II.

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围手术期正念训练不能改善全膝关节置换术患者的睡眠质量

背景：全膝关节置换术（TKA）术后即刻睡眠质量下降。目前尚无研究前瞻性分析正念冥想（MM）对TKA后睡眠质量的影响。本研究的目的是确定MM联合TKA是否能在术后2周、6周或12周改善匹兹堡睡眠质量指数（PSQI）。方法前瞻性纳入原发性单侧TKA患者，随机分为3组。围手术期MM组分别在术前、术前1天、术后3天和术后2周接受MM治疗。术前MM组仅在术前访视时接受MM治疗。对照组不接受MM。MM由2名有执照的专业心理学家指导观众通过15分钟的MM视频组成。在术后2周、6周和12周收集人口统计数据并完成问卷调查。患者被排除在先前的酒精/药物依赖和无法亲自就诊的基础上。一项先验分析需要每组75名患者才能达到80%的疗效。结果共纳入282例患者，随机分为对照组（n = 94）、术前MM组（n = 94）、围手术期MM组（n = 94）。在年龄（P = 0.24）、性别（P = 0.77）、体重指数（P = 0.18）、美国麻醉医师协会（P = 0.17）或住院时间（P = 0.18）方面，各队列之间没有差异。各组间术前PSQI评分差异无统计学意义（对照组8.4±4.1，术前MM 7.9±3.8，围手术期MM 7.8±4.3,P = 0.58）。术后2周，两组间PSQI差异无统计学意义（对照组10.7±4.3 MM，术前10.8±4.4 MM，围手术期9.9±4.4 MM; P = 0.33）。这种情况持续到6周（对照组10.1±4.2 MM，术前10.0±3.9 MM，围手术期9.5±4.4 MM; P = 0.62）。12周时，PSQI恢复到术前水平，各组间无差异（对照组8.7±4.4 MM，术前8.3±4.2 MM，围手术期7.8±4.1 MM; P = .264）。结论正念训练对TKA术后任何时间点的睡眠质量均无改善作用。进一步的研究是有必要的，因为改善睡眠质量可能会促进TKA的康复。证据水平：治疗性二级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.