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Among 282 patients, sleep quality showed no significant between-group differences at any time point. The findings indicate perioperative mindfulness training does not enhance postoperative sleep quality after 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\nContents lists available at ScienceDirect  \nArthroplasty Today  \njournal homepage: [http://www . arthroplastytoday . org/](http://www . arthroplastytoday . org/)  \n| Original Research\u003Cbr>Perioperative Mindfulness Training Does Not Improve Sleep Quality in Patients Undergoing Total Knee Arthroplasty\u003Cbr>Jessica L.H. Phillips, MDa, Makenna R. Hemmerle, MSb, Roseann M. Johnson, BSb, Hayley E. Ennis, MDa, Jason J. Jennings, MD, DPTb, c, d, *\u003Cbr>a Department of Orthopaedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA b Colorado Joint Replacement, AdventHealth Porter Hospital, Denver, CO, USA\u003Cbr>c Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, USA d Department of Physical Therapy, University of Delaware, Newark, DE, USA |  |  |\n| --- | --- | --- |\n| a r t i c l e i n f o |  | a b s t r a c t |\n| Article history:\u003Cbr>Received 2 July 2025\u003Cbr>Received in revised form\u003Cbr>27 October 2025 Accepted 4 November 2025 Available online xxx |  | Background: Sleep quality declines in the immediate postoperative period following total knee arthroplasty (TKA). No prior study has prospectively analyzed the impact of mindfulness meditation (MM) on sleep quality following TKA. The purpose of this study was to determine whether MM administered in conjunction with TKA results in any improvement in Pittsburgh Sleep Quality Index (PSQI) at 2, 6, or 12 weeks postoperatively.\u003Cbr>Methods: Patients undergoing primary unilateral TKA were prospectively enrolled and randomized into 3 cohorts. The perioperative MM cohort received MM at the preoperative visit, the day preceding surgery, 3 days postoperatively, and 2 weeks postoperatively. The preoperative MM group only received MM at the preoperative visit. Controls received no MM. MM consisted of a video of 2 licensed professional psychologists guiding viewers through a 15-minute MM. Demographic data were collected and questionnaires completed at 2, 6, and 12 weeks postoperatively. Patients were excluded on the basis of prior alcohol/drug dependence and inability to present to in-person visits. An a priori analysis required 75 patients per cohort to achieve 80% power.\u003Cbr>Results: Two hundred eighty-two patients were enrolled and randomized to 3 groups: control (n = 94), preoperative MM (n = 94), and perioperative MM (n = 94). There were no differences between cohortsin age (P = .24), sex (P = . 77), body mass index (P = .18), American Society of Anesthesiologists (P = .17), or length of stay (P = .18). No differences between cohorts in preoperative PSQI scores were noted (8.4 ± 4.1 control, 7.9 ± 3.8 preoperative MM, 7.8 ± 4.3 perioperative MM; P = .58). Two weeks postoperatively, there remained no PSQI differences between groups (10.7 ± 4.3 control, 10.8 ± 4.4 preoperative MM, 9.9 ± 4.4 perioperative MM; P = .33). This persisted at 6 weeks (10.1 ± 4.2 control, 10.0 ± 3.9 preoperative MM, 9.5 ± 4.4 perioperative MM; P = .62). At 12 weeks, PSQI returned to preoperative levels and there remained no difference among cohorts (8.7 ± 4.4 control, 8.3 ± 4.2 preoperative MM, 7.8 ± 4.1 perioperative MM; P = .264).\u003Cbr>Conclusions: Mindfulness training did not improve postoperative sleep quality at any time point following TKA. Further studies are warranted, as improving sleep quality may enhance TKA rehabilitation.\u003Cbr>Level of Evidence: Therapeutic Level II.\u003Cbr>© 2025 The Authors. Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/](http://creativecommons.org/)[ ](http://creativecommons.org/)licenses/by-nc-nd/4.0/). |\n| Keywords:\u003Cbr>Total knee arthroplasty Sleep\u003Cbr>Meditation |  |  |\n\n* Corresponding author. 2535 S Downing St. Suite 100, Denver, CO 80210, USA. Tel.: +1 720 524 1367.  \nE-mail [address:](address: makenna.hemmerle@adventhealth.com)[ makenna.hemmerle@adventhealth.com](address: makenna.h","cbCaija71TPKTwDU","https://ap.wps.com/l/cbCaija71TPKTwDU","pdf",850440,"English","# Introduction\n# Methods\n# Results\n# Conclusions","[{\"question\":\"What was the study purpose regarding mindfulness meditation and TKA?\",\"answer\":\"To determine whether mindfulness meditation (MM) administered with total knee arthroplasty improves Pittsburgh Sleep Quality Index (PSQI) outcomes at 2, 6, and 12 weeks after surgery.\"},{\"question\":\"How were patients assigned to the different mindfulness groups?\",\"answer\":\"Patients undergoing primary unilateral TKA were randomized into three cohorts: control (no MM), preoperative MM (MM only at the preoperative visit), and perioperative MM (MM before surgery, around surgery, and two weeks postoperatively).\"},{\"question\":\"Did perioperative mindfulness training improve sleep quality at 2, 6, or 12 weeks?\",\"answer\":\"No. PSQI scores did not differ significantly between the groups at 2 weeks, persisted at 6 weeks, and at 12 weeks returned to preoperative levels without meaningful between-cohort differences.\"}]","Perioperative Mindfulness Training Does Not Improve Sleep Quality in Patients Undergoing Total Knee Arthroplasty | PDF",1790693097,15]