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Improvement in Sleep Disturbance Following Anatomic and Reverse Shoulder Arthroplasty.

Austin Vegas1, Jose R Garcia2, Julie Glener3

  • 1Larkin Community Hospital, South Miami, Florida.

The Journal of Bone and Joint Surgery. American Volume
|July 20, 2023
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Summary

Shoulder arthroplasty significantly improves sleep for patients with arthritis and rotator cuff issues. Both anatomic total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA) offer rapid sleep recovery, with comfort improving within 3 months.

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Area of Science:

  • Orthopedic Surgery
  • Sleep Medicine
  • Reconstructive Surgery

Background:

  • Sleep disturbance is a common complaint among patients with arthritis and rotator cuff disease.
  • Previous small studies indicated sleep benefits after shoulder arthroplasty, but large-scale data were lacking.

Purpose of the Study:

  • To assess the impact of shoulder arthroplasty on sleep quality.
  • To compare sleep recovery speed and improvement plateaus between anatomic total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA).

Main Methods:

  • Retrospective analysis of 989 patients (517 TSA, 472 RSA) who underwent shoulder arthroplasty between 2012 and 2021.
  • Evaluation of patient-reported outcomes including pain scores (VAS) and sleep-specific questions from the Simple Shoulder Test (SST) and American Shoulder and Elbow Surgeons (ASES) questionnaires.
  • Comparison of preoperative and postoperative data at 3-month, 6-month, 1-year, and most recent follow-ups (median 36 months for TSA, 25 months for RSA).

Main Results:

  • Both TSA and RSA groups showed significant postoperative improvements in comfortable sleep and sleeping on the affected side (p < 0.001).
  • Comfortable sleep recovery plateaued at 3 months, while sleeping on the affected side plateaued at 6 months.
  • At most recent follow-up, 13.2% (TSA) and 16.0% (RSA) still had difficulty sleeping comfortably, and 31.4% (TSA) and 36.8% (RSA) could not sleep on the operative side.

Conclusions:

  • Shoulder arthroplasty, encompassing both TSA and RSA, leads to significant and swift improvements in patients' ability to sleep comfortably.
  • While sleep on the affected side also improves, the recovery is less rapid and may not fully resolve for a notable percentage of patients.