Sleep and total knee replacement

Pre-operative focus groups and post-operative telephone interviews with patients undergoing total knee replacement surgery. Study data is focused on sleep experiences and views on sleep interviews. This study was funded by the NIHR Bristol Biomedical Research Centre.

The aim of this study was the preliminary development of a new non-pharmacological approach to improve sleep quality and duration in patients undergoing total knee replacement. Total knee replacement is the third most common non-emergency procedure in the UK. It involves replacing a damaged or painful joint with an artificial joint in order to reduce pain and improve function. Results after a total knee replacement are good, however up to 20% of patients will continue to experience dissatisfaction with their surgical outcome and mild to severe long-term pain after surgery. In order address this issue, new approaches are needed to improve surgical outcomes and reduce pain in this patient group. Sleep is bidirectionally linked to pain and improving sleep in this population has the potential to significantly benefit a wide range of patients and improve long-term outcomes. The first step in this process is to fully understand the problem and its causes. To date, very little is known about the exact nature of sleep behaviour and problems in the total knee replacement population.

This study collected data on individual sleep experiences and patterns through the use of qualitative focus groups and interviews. Available data include five pre-operative focus groups and seven post-operative telephone interviews. Before surgery, focus groups explored sleep experiences and views about existing sleep interventions (cognitive behavioural therapy for insomnia, exercise, relaxation, mindfulness, sleep hygiene), and barriers to engagement. After surgery, telephone interviews explored any changes in sleep and views about intervention appropriateness.