Targeted Nighttime Noise Control During Key Sleep Periods Combined with Rehabilitation Nursing in Elderly Patients after Knee Arthroplasty.

OBJECTIVE

To investigate the effect of combining conventional rehabilitation nursing with targeted noise control during the key sleep period on clinical outcomes in elderly patients with knee osteoarthritis (KOA) after knee arthroplasty.

METHODS

This retrospective study included 100 elderly patients with KOA who underwent knee arthroplasty at the Orthopedics Department of the Second Affiliated Hospital of Zhejiang University School of Medicine, between May 2023 and September 2024. According to the actual nursing records and ward noise management implemented during hospitalization, patients were divided into a control group ( n  = 50), which received conventional orthopedic rehabilitation nursing and routine noise control, and an observation group ( n  = 50), which received conventional orthopedic rehabilitation nursing plus additional targeted nighttime noise control during key sleep period. Propensity score matching was used to exclude baseline confounding. The incidence and duration of postoperative delirium, Sedation-Agitation Scale (SAS) scores, ward noise levels ( LAeq , LAmax ), and Richards-Campbell Sleep Questionnaire (RCSQ) scores were compared between the two groups.

RESULTS

The observation group showed a significantly lower postoperative delirium incidence and a shorter duration of delirium than the control group (both P < 0.05). During the key sleep period (02:00-04:00), both LAeq and LAmax values were significantly lower in the observation group (both P < 0.05). The observation group also had lower SAS scores and higher RCSQ scores (both P < 0.05). Moreover, postoperative recovery was superior in the observation group, as reflected by earlier first out-of-bed mobilization, greater knee flexion at discharge, and a shorter length of hospital stay (all P < 0.05).

CONCLUSION

In this retrospective study, conventional orthopedic rehabilitation nursing combined with targeted nighttime noise control during key sleep periods was significantly associated with a lower incidence of postoperative delirium, better sleep quality, and faster functional recovery in elderly patients after knee arthroplasty.