About this trial
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.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
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
Disqualifiers
Chronic opioid use prior to surgery
Revision TJA
Primary diagnosis other than osteoarthritis (e.g., fracture, posttraumatic arthritis, AVN)
Hearing impairment precluding music listening
Trial design
Parallel
Treatments tested in this trial
Music via Headphones
Other interventionPatient-selected music will be played through their headphones
Treatment groups
Trial outcomes
Primary outcomes
Change in State Anxiety Score as Measured by the Six-Item Short Form of the Spielberger State-Trait Anxiety Inventory (STAI-6)
The STAI-6 is a validated 6-item short form of the state anxiety subscale of the Spielberger State-Trait Anxiety Inventory. Each item is scored from 1 to 4, for a raw total of 6 to 24. The raw total is prorated to the full-scale equivalent (multiplied by 20/6), giving a score range of 20 to 80. Higher scores indicate greater anxiety (worse outcome). The outcome is the change in prorated score from arrival in the preoperative holding area (T1) to immediately before transport to the operating room (T2).
Secondary outcomes
Postoperative Anxiety Measured by Numeric Rating Scale (NRS)
Self-reported anxiety on an 11-point numeric rating scale from 0 (no anxiety) to 10 (worst anxiety imaginable). Higher scores indicate greater anxiety (worse outcome).
Postoperative Pain Measured by Numeric Rating Scale (NRS)
Self-reported pain on an 11-point numeric rating scale from 0 (no pain) to 10 (worst pain imaginable). Higher scores indicate greater pain (worse outcome).
Global Surgical Experience Measured by Numeric Rating Scale (NRS)
Patient-reported overall satisfaction with the perioperative experience on an 11-point numeric rating scale from 0 (worst possible experience) to 10 (best possible experience). Higher scores indicate a better experience (better outcome).
Intraoperative Sensory Recall
Proportion of participants reporting recall of intraoperative sensory experiences (e.g., sounds, conversations, sensations), assessed with a structured postoperative questionnaire. Responses are recorded as yes/no for each sensory domain. Reported recall is considered a worse outcome.
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