Sleep Disorders Research Center, Health Institute, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
Research Center for Environmental Determinants of Health (RCEDH), School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Orthop Surg Res. 2021 May 28;16(1):342. doi: 10.1186/s13018-021-02493-4.
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.
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.
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).
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.
全膝关节置换术（TKA）是一种被广泛接受的有效治疗方法，可恢复功能、缓解疼痛、提高晚期骨关节炎患者的生活质量。这种主要手术的一个并发症是睡眠质量受损。本研究检查了接受 TKA 手术前后患者的睡眠质量。
使用系统搜索在三个在线数据库：PubMed、Scopus 和 Cochrane library 中获得所有相关记录。在检索到的 177 条记录中，只有 8 条符合纳入标准。由于缺乏足够的数据，只有四项研究进入了荟萃分析。从患者记录中提取基于匹兹堡睡眠质量指数（PSQI）报告的睡眠质量值，根据术前基线在术后 4-6 周（SMD-0.16；95%CI-1.05 至 0.74；P=0.0）和术后 3-6 个月（SMD-0.92；95%CI-1.61 至-0.24；P=0.0）两个时间点分析数据。使用随机效应模型进行分析。
荟萃分析结果显示，在术后 4-6 周（SMD-0.16；95%CI-1.05 至 0.74；P=0.0）和术后 3-6 个月（SMD-0.92；95%CI-1.61 至-0.24；P=0.0）从术前基线两个时间点，手术对睡眠质量的改善有显著差异。
结果表明，TKA 通常可改善患者的睡眠质量。尽管一些研究报告在接近手术的时期（尤其是在手术后的早期）睡眠质量受到干扰，但所有研究都报告在术后晚期睡眠质量得到改善。
