Article Text

Download PDFPDF
High incidence of acute self-reported sleep disturbances in patients following arthroscopic-assisted knee surgery
  1. Nicholas N DePhillipo1,2,
  2. Robert S Dean1,
  3. Lars Engebretsen3,
  4. Christopher M Larson1,
  5. Jill Monson1,
  6. Robert F LaPrade1
  1. 1 Twin Cities Orthopedics, Edina-Crosstown, Edina, Minnesota, USA
  2. 2 Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
  3. 3 Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
  1. Correspondence to Professor Nicholas N DePhillipo, Twin Cities Orthopedics, Edina, Minnesota, USA; Nickd.atc{at}gmail.com

Abstract

Objectives To evaluate the self-reported incidence of sleep disturbances, defined as ≤7 hours of sleep per 24-hour period, in patients undergoing arthroscopic-assisted knee surgery.

Methods Patients who underwent arthroscopic knee surgery over the course of a 4-month period were prospectively included. Patients were excluded if a history of insomnia or other sleep altering medical history was reported. Self-reported sleep metrics included average number of hours of sleep per night, average number of awakenings during sleep per night, perceived quality of sleep, average pain level during sleep and number of hours of physical activity/therapy per week. Data were collected at weeks 1, 3, and 6 postoperatively. Joint circumference was measured on postoperative day 1 and served as an indicator of a knee effusion. Paired t-tests were used to compare preoperative to postoperative hours of sleep. Simple and multiple linear regression were used to evaluate relationships between surgical variables and postoperative sleep metrics.

Results There were 123 patients who underwent arthroscopic knee surgery during the prospective enrolment period; 83 patients were included in the final analysis. The overall incidence of preoperative sleep disturbances was 20% (n=17). The overall incidence of self-reported postoperative sleep disturbances was 99%, 96% and 90% at weeks 1, 3 and 6, respectively. The average number of hours slept was significantly reduced at 1, 3 and 6 weeks postoperatively compared with the preinjury state (p<0.001). Knee joint circumference had a significantly negative correlation with average number of hours of sleep in the first 6 weeks postoperatively (R=−0.704; p=0.001). Surgical variables including severity of surgery, weekly postoperative pain level and weekly hours of postoperative physical therapy were not significant independent predictors of acute postoperative sleep disturbances (p>0.05).

Conclusion Sleep disturbances were commonly reported in patients following arthroscopic knee surgery without correction of sleep metrics by 6 weeks postoperatively. The majority of sleep disturbances in this cohort correlated with an increased knee effusion. A multidisciplinary team approach is recommended to counsel patients regarding the potential for and problems with acute sleep disturbances following arthroscopic knee surgery.

Level of evidence: 3.

  • anterior cruciate ligament
  • knee
  • orthopaedic sports medicine
  • physicians

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information.

Statistics from Altmetric.com

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information.

View Full Text

Footnotes

  • Twitter @JillMonsonPT

  • Contributors NND: primary writing contribution, data collection, data analysis, idea generation, formatting, patient consent. RD: primary writing contribution, data collection, idea generation. LE: significant writing contribution, data collector, data analysis. CML: significant writing contribution, data collector, data analysis. JM: writing contribution, data collector, data analysis. RL: critical edits, manuscript writing and idea generation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.