Patients had improvements in sleep comfortability following shoulder arthroplasty
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Key takeaways:
- Anatomic total or reverse shoulder arthroplasty improved patients’ ability to sleep comfortably.
- Most patients were able to sleep comfortably on their operative side by 6 months.
Results published in the Journal of Bone and Joint Surgery found patients who underwent anatomic total or reverse shoulder arthroplasty had “significant and rapid” improvements in sleep disturbance after surgery.
Researchers performed a retrospective analysis of patients who reported sleep disturbance prior to undergoing a shoulder arthroplasty procedure between 2012 and 2021. The study included 517 patients who underwent TSA and 472 patients who underwent RSA with complete follow-up.
According to the study, outcome measures included a sleep-related questionnaire, VAS pain scores, the Simple Shoulder Test and American Shoulder and Elbow Surgeons questionnaires. Researchers analyzed outcomes preoperatively and at 3-month, 6-month and 1-year postoperative time points.
Overall, researchers found “significant and rapid improvements” in patients’ ability to sleep comfortably after surgery in both the TSA and RSA cohorts. They found a less significant improvement in ability to sleep on their operative side. They noted the ability to sleep comfortably plateaued at 3 months, while the ability to sleep on their operative side plateaued at 6 months.
At the time of most recent follow-up, 13.2% of the TSA cohort and 16% of the RSA cohort reported they still could not sleep comfortably, while 31.4% of the TSA cohort and 36.8% of the RSA cohort reported they still could not sleep on their operative side.
“Both TSA and RSA were highly effective for reducing sleep disturbances,” the researchers wrote in the study. “The ability to sleep comfortably and the ability to sleep on the affected side improved significantly for both the TSA and RSA groups at various time intervals,” they concluded.
Perspective
Back to TopGrant E. Garrigues, MD, and John P. Scanaliato, MD
Recently, in the Journal of Bone and Joint Surgery, Austin Vegas, DO, and colleagues took advantage of the Holy Cross Shoulder and Elbow Repository to investigate improvements in sleep following both anatomic TSA and RSA. Overall, 517 patients who underwent an anatomic TSA and 472 patients who underwent RSA were eligible for inclusion in their study. Preoperatively, 88.8% of anatomic TSA patients and 82% of RSA patients reported an inability to sleep comfortably, and approximately 50% of patients in each group noted an inability to sleep on their affected shoulder. Promisingly, by 12 months postoperatively, only 13.2% of anatomic TSA patients and 14.8% of RSA patients were still unable to sleep comfortably. However, nearly one-third of patients in both groups noted an inability to sleep on the operative shoulder. With respect to the sleep improvement timeline, the rate of improvement in overall sleep quality plateaus at 3 months postoperatively, while the rate of improvement in the ability to sleep on the operative side plateaus at 6 months postoperatively. This study provides excellent data on the timeline and likelihood of improvement in a common chief complaint with shoulder pathology – disrupted sleep – and is helpful in patient counseling and expectations.
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