A prospective study comparing sleep quality using Pittsburgh Sleep Quality Index at 8 weeks after robotic-assisted versus conventional total knee arthroplasty: a single-center study.

Total knee arthroplasty (TKA) is crucial for alleviating pain and improving the quality of life in patients with end-stage knee arthritis. Postoperative sleep disturbances are common and can persist for months following the surgery, potentially hindering the overall rehabilitation process and the quality of life. Robotic-assisted TKA (RATKA) offers greater precision and less invasiveness than conventional TKA (CTKA), potentially improving postoperative sleep quality. This study aims to compare sleep quality in patients undergoing RATKA versus CTKA. This prospective study (January 2024-June 2024) included 68 patients undergoing unilateral TKA for end-stage osteoarthritis, randomized into RATKA [Cuvis Joint Robotic Assisted System] (n = 34) and CTKA (n = 34) groups. Both the procedures were performed under spinal anesthesia along with Adductor Canal Block. Patients with pre-existing psychiatric conditions, diagnosed sleep disorders, or insomnia medication use were excluded. Postoperatively, patients followed a standardized multimodal pain management protocol. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) at 8 weeks post-TKA. Statistical analysis included Student's t test, effect size calculation, and confidence intervals, with significance set at p < 0.05. The baseline and preoperative clinical characteristics were comparable between the groups. At 8 weeks, the RATKA group had a mean PSQI score of 5.68 ±0.71, significantly lower than the CTKA group's score of 6.25 ± 0.92 (p = 0.0057, Cohen's d = 0.68) indicating better sleep quality in the RATKA group. RATKA was associated with significantly better postoperative sleep quality than CTKA at 8 weeks, as indicated by lower PSQI scores. These findings provide preliminary evidence supporting the potential benefits of robotic-assisted techniques in improving sleep outcomes following TKA. RATKA was associated with significantly better postoperative sleep quality than CTKA, likely due to reduced pain, soft-tissue preservation, and optimized implant positioning. These findings suggest potential advantages of robotic-assisted techniques in TKA recovery. Future multicenter studies with larger, more diverse populations and longer follow-up are needed to validate these results.