Columbia University
Many patients feel anxious before joint replacement surgery. This anxiety is common - affecting roughly 1 in 3 patients - and research has shown that patients who are more anxious before surgery tend to have more pain afterward and may need more pain medication during recovery. Listening to music before medical procedures has been shown to reduce anxiety in many types of surgery. In fact, a recent analysis of 20 studies found that music works about as well as anti-anxiety medication for calming patients before surgery, with about 1 in 4 patients experiencing a meaningful benefit. However, almost all of this research has been done in other types of surgery. No study has specifically tested whether letting patients listen to their own preferred music before hip or knee replacement surgery reduces their anxiety. This study will randomly assign 52 patients scheduled for hip or knee replacement surgery to one of two groups: one group will listen to music of their choice through noise-cancelling headphones while waiting for surgery (for at least 20 minutes), and the other group will receive the usual preoperative care without music. Patients will fill out a brief 6-question anxiety survey when they arrive in the preoperative area and again just before being taken to the operating room. The study will also ask patients about their pain, anxiety, and overall experience after surgery, and will review their medical charts to see how much sedation and pain medication was used during the procedure. If music is shown to reduce anxiety in this setting, it could be easily adopted by any hospital at very low cost, offering patients a simple, drug-free way to feel calmer before their surgery.
Preoperative anxiety affects 20-33% of patients undergoing total joint arthroplasty (TJA) and is independently associated with worse postoperative pain, higher opioid consumption, and lower functional outcomes. Music intervention is a well-established non-pharmacologic anxiolytic, with meta-analytic evidence demonstrating a standardized mean difference (SMD) of 0.72 (95% CI 0.92 to 0.53) for perioperative anxiety reduction using validated instruments, corresponding to a number needed to treat (NNT) of 4. However, the evidence base derives predominantly from general surgical populations. The on…
Inclusion Criteria: * Adults 18 years or older undergoing primary THA, TKA, or UKA for osteoarthritis * Planned spinal/regional anesthesia * Willingness to undergo randomization * Ability to provide informed consent in English Exclusion Criteria: * Chronic opioid use prior to surgery * Revision TJA * Primary diagnosis other than osteoarthritis (e.g., fracture, posttraumatic arthritis, AVN) * Hearing impairment precluding music listening * Active psychiatric disorder requiring current pharmacotherapy * Pregnancy * Inability to provide informed consent in English
Patient-selected music will be played through their headphones