Which Interventions Are Effective in Treating Sleep Disturbances After THA or TKA? A Systematic Review

Area of Science:

• Orthopedic Surgery
• Sleep Medicine
• Pharmacology

Background:

• Postoperative sleep disturbance is prevalent after total joint arthroplasty (TJA).
• Poor sleep quality is linked to increased pain and functional deficits.
• Evidence-based interventions are needed to improve sleep post-TJA.

Approach:

• Systematic review adhering to PRISMA guidelines.
• Searched Medline, Embase, Cochrane Central, and Web of Science databases.
• Included 14 studies (12 RCTs, 2 comparative) of adult TJA patients.

Key Points:

• Melatonin and rofecoxib demonstrated potential sleep quality benefits in the first postoperative week.
• Rofecoxib is withdrawn globally; celecoxib is an alternative COX-2 inhibitor.
• No other interventions showed significant clinical benefit.

Conclusions:

• Most studied interventions lack sufficient evidence for routine TJA use.
• Melatonin and rofecoxib offer potential benefits but require careful consideration of side effects and contraindications.
• Further research is needed for interventions with favorable safety profiles for post-TJA sleep improvement.