High incidence of acute self-reported sleep disturbances in patients following arthroscopic-assisted knee surgery

ObjectivesTo 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.MethodsPatients 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.ResultsThere 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).ConclusionSleep 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.

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Opioid Requirement following Arthroscopic Knee Surgery: Are There Predictive Factors Associated with Long-Term Use

The Journal of Knee Surgery ◽

10.1055/s-0039-3400754 ◽

2019 ◽

Author(s):

Georgina Glogovac ◽

Mark Kennedy ◽

Michael D. Parman ◽

Katherine A. Bowers ◽

Angelo J. Colosimo ◽

...

Keyword(s):

Opioid Consumption ◽

Knee Surgery ◽

Area Deprivation ◽

Pain Level ◽

Opioid Use ◽

Arthroscopic Knee Surgery ◽

Factors Associated ◽

Patient Reported ◽

Arthroscopic Knee ◽

The Impact

AbstractThe purpose of this study is to identify patterns of postoperative narcotic use and determine the impact of psychosocial and perioperative factors on postoperative opioid consumption following arthroscopic knee surgery. Fifty consecutive patients undergoing arthroscopic knee surgery were prospectively enrolled. Patients were contacted via telephone at 1 week postoperatively to report their pain level and opioid consumption. The patient was contacted again at 2 weeks, 4 weeks, and 90 days as necessary until opioid cessation, at which time the patient's plan for unused pills was inquired. Opioid consumption was compared using t-tests and one-way analysis of variance for demographic and surgical factors. Linear regression was used to determine whether the Pain Catastrophizing Scale (PCS), Resilience Scale (RS-11), International Knee Documentation Committee questionnaire, or patient-reported pain at 1 week predicted higher opioid consumption. The average morphine equivalent dose of opioid consumption was 142 mg. Sixty-four percent consumed less than 100 mg, and 68% discontinued opioid use by 1 week postoperatively. Seventy-four percent reported surplus pills, and 49% of those patients plans for pill disposal. Factors associated with higher consumption included undergoing a major procedure, having a regional anesthesia block, and higher area deprivation index score (p < 0.05). Higher PCS scores and reported average pain level at 1 week were predictive of higher opioid consumption (p < 0.05). In conclusion, a majority of patients undergoing outpatient knee surgery did not require the entirety of their narcotic prescription. The majority of patients consumed less than 100 mg of morphine equivalents and discontinued opioid use by 1 week postoperatively. Ligament reconstruction, living in an area with a higher index of deprivation, and higher score on the PCS were associated with greater opioid consumption. Overall, patient knowledge regarding opioid disposal was poor, and patients would likely benefit from additional education prior to surgery.

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Resident Involvement in Arthroscopic Knee Surgery Is Not Associated With Increased Short-term Risk to Patients

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120967460 ◽

2020 ◽

Vol 8 (12) ◽

pp. 232596712096746

Author(s):

Bryce A. Basques ◽

Bryan M. Saltzman ◽

Shane S. Korber ◽

Ioanna K. Bolia ◽

Erik N. Mayer ◽

...

Keyword(s):

Adverse Events ◽

Operative Time ◽

Statistical Significance ◽

Knee Surgery ◽

Improvement Program ◽

Level Of Evidence ◽

Arthroscopic Knee Surgery ◽

Increased Risk ◽

Resident Involvement ◽

Arthroscopic Knee

Background: Whether resident involvement in surgical procedures affects intra- and/or postoperative outcomes is controversial. Purpose/Hypothesis: The purpose of this study was to compare operative time, adverse events, and readmission rate for arthroscopic knee surgery cases with and without resident involvement. We hypothesized that resident involvement would not negatively affect these variables. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of the prospectively maintained National Surgical Quality Improvement Program was performed. Patients who underwent arthroscopic knee surgery between 2005 and 2012 were identified. Multivariate Poisson regression with robust error variance was used to compare the rates of postoperative adverse events and readmission within 30 days between cases with and without resident involvement. Multivariate linear regression was used to compare operative time between cohorts. Because of multiple statistical comparisons, a Bonferroni correction was used, and statistical significance was set at P < .004. Results: A total of 29,539 patients who underwent arthroscopic knee surgery were included in the study, and 11.3% of these patients had a resident involved with the case. The overall rate of adverse events was 1.62%. On multivariate analysis, resident involvement was not associated with increased rates of adverse events or readmission. Resident cases had a mean 6-minute increase in operative time ( P < .001). Conclusion: Overall, resident involvement in arthroscopic knee surgery was not associated with an increased risk of adverse events or readmission. Resident involvement was associated with only a mean increased operative time of 6 minutes, a difference that is not likely to be clinically significant. These results support the safety of resident involvement with arthroscopic knee surgery.

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Faculty Opinions recommendation of Intra-articular magnesium is effective for postoperative analgesia in arthroscopic knee surgery.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.30416.486915 ◽

2006 ◽

Author(s):

Gordon Drummond

Keyword(s):

Postoperative Analgesia ◽

Knee Surgery ◽

Arthroscopic Knee Surgery ◽

Arthroscopic Knee

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Intra-articular magnesium to alleviate postoperative pain after arthroscopic knee surgery: a meta-analysis of randomized controlled trials

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02264-1 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Lijun Shi ◽

Haiyun Zhu ◽

Jinhui Ma ◽

Li-Li Shi ◽

Fuqiang Gao ◽

...

Keyword(s):

Postoperative Pain ◽

Randomized Controlled Trials ◽

Pain Intensity ◽

Opioid Consumption ◽

Knee Surgery ◽

Cochrane Library ◽

Controlled Trials ◽

Arthroscopic Knee Surgery ◽

Randomized Controlled ◽

Arthroscopic Knee

Abstract Objective We aimed to evaluate the safety and efficacy of intra-articular (IA) magnesium (Mg) for postoperative pain relief after arthroscopic knee surgery. Methods We searched PubMed, Embase, Medline, Cochrane library, and Web of Science to identify randomized controlled trials that compared postoperative pain outcomes with or without IA Mg after knee arthroscopy. The primary outcomes were pain intensity at rest and with movement at different postoperative time points and cumulative opioid consumption within 24 h after surgery. Secondary outcomes included the time to first analgesic request and side effects. Results In total, 11 studies involving 677 participants met the eligibility criteria. Pain scores at rest and with movement 2, 4, 12, and 24 h after surgery were significantly lower, doses of supplementary opioid consumption were smaller, and the time to first analgesic requirement was longer in the IA Mg group compared with the control group. No significant difference was detected regarding adverse reactions between the groups. Conclusions Intra-articular magnesium is an effective and safe coadjuvant treatment for relieving postoperative pain intensity after arthroscopic knee surgery. Protocol registration at PROSPERO: CRD42020156403.

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Clinical analgesic efficacy and side effects of dexmedetomidine in the early postoperative period after arthroscopic knee surgery

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2007.06.013 ◽

2007 ◽

Vol 19 (8) ◽

pp. 576-582 ◽

Cited By ~ 29

Author(s):

Maria E. Gómez-Vázquez ◽

Eduardo Hernández-Salazar ◽

Abel Hernández-Jiménez ◽

Arturo Pérez-Sánchez ◽

Vilma A. Zepeda-López ◽

...

Keyword(s):

Side Effects ◽

Postoperative Period ◽

Analgesic Efficacy ◽

Early Postoperative Period ◽

Knee Surgery ◽

Arthroscopic Knee Surgery ◽

Arthroscopic Knee

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Endovascular repair of a pseudoaneurysm of the popliteal artery following arthroscopic knee surgery: case report and review of literature

Vascular ◽

10.1177/1708538113477799 ◽

2013 ◽

Vol 21 (2) ◽

pp. 102-104 ◽

Cited By ~ 5

Author(s):

Zachary Aburahma ◽

Stephen M Hass

Keyword(s):

Case Report ◽

Endovascular Repair ◽

Popliteal Artery ◽

Knee Surgery ◽

Review Of Literature ◽

Safe Alternative ◽

Arthroscopic Knee Surgery ◽

Arthroscopic Knee

We report a case of a pseudoaneurysm of the popliteal artery following arthroscopic knee surgery. Endovascular repair was successfully used as the treatment for this patient and studies have shown this to be a safe alternative to surgery.

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