💠 Limited Efficacy of Pharmacological Interventions for Improving Postoperative Sleep Quality in Primary Total Joint Arthroplasty Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
👥 Negarsadat Namazi, Ali Salmani, Ariyan Ayati, Amir Mehrvar*, Mohammad Poursalehian, Sina Hajiaghajani
📔 Journal of Arthroplasty (Q1)
🗓 September 2025
🗂 Systematic review
📄 Abstract:
Background: Sleep disturbances are prevalent after primary total joint arthroplasty (TJA), yet the effectiveness of pharmacological interventions remains unclear.
Methods: We conducted a systematic review and meta-analysis of randomized controlled trials evaluating pharmacological interventions for sleep quality in TJA patients.
Results: Twenty-four RCTs comprising 2,934 patients were included. Zolpidem significantly improved sleep quality up to 3 weeks postoperatively (Hedges’ g = −1.51; P < .001). Antiepileptics were also effective (Hedges’ g = −0.603; P < .001) but were associated with more adverse effects. Melatonin and corticosteroids did not show significant efficacy.
Conclusions: Evidence suggests limited efficacy of pharmacological interventions, with zolpidem providing short-term benefits but safety concerns restricting its routine use. Further high-quality studies are warranted.
🔗 https://doi.org/10.1016/j.arth.2025.08.071
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