Music Interventions in Anxiety and Pain Management in Patients Undergoing Total Knee and Hip Arthroplasty
DOI:
https://doi.org/10.65150/EP-jsshrs/V2E6/2026-08Keywords:
music intervention, total knee arthroplasty, total hip arthroplasty, preoperative anxiety, narrative reviewAbstract
Background: Preoperative anxiety and postoperative pain represent two prominent clinical challenges in patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA). Music interventions, encompassing passive music listening and therapist-guided music therapy, are attracting growing interest as safe, low-cost non-pharmacological options within perioperative opioid-minimization strategies.
Objectives: To synthesize and critically appraise scientific evidence from 2020 to 2025 on the effectiveness of music interventions for anxiety and pain in arthroplasty patients; to clarify proposed neurobiological mechanisms; to identify moderating factors of outcomes; and to discuss clinical implications and priority research directions.
Methods: A narrative review with transparent search, conducted in accordance with SANRA guidelines, was performed. This approach was selected to enable critical synthesis and conceptual integration across diverse study designs, including randomized controlled trials (RCTs), systematic reviews, and mechanistic studies, rather than providing a quantitative pooled estimate. Purposive searches were conducted across five electronic databases for the period 2020 to 2025. Evidence was stratified according to its degree of directness to the TKA/THA population: core evidence from studies conducted specifically in orthopaedics and joint arthroplasty; contextual evidence from multispecialty perioperative meta-analyses; and mechanistic evidence from neurobiological research.
Main Results: Evidence suggests that music interventions are associated with reductions in preoperative anxiety and postoperative pain of small to moderate effect size in orthopaedic populations (standardized mean difference [SMD] approximately -0.27 to -0.40; a negative SMD denotes reduction in the intervention group relative to the control group). One TKA-specific meta-analysis found no statistically significant reduction in pain Visual Analogue Scale (VAS) scores, yet documented significant shift in autonomic nervous system balance. Contextual evidence from multispecialty meta-analyses yielded larger effect sizes (SMD approximately -0.90) that cannot be directly extrapolated to TKA/THA. Evidence regarding prevention of postoperative delirium remains indirect.
Conclusions: Current evidence suggests that music interventions may confer clinical benefit in perioperative management of joint arthroplasty. However, TKA/THA-specific evidence remains more limited than that available for broader surgical populations and requires reinforcement by adequately powered, multicenter randomized controlled trials.
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Copyright (c) 2026 Trần Thị Thu Trang, Nguyen Thuy Van, Dinh Thi Thanh Huyen, Nguyen Thi Hao, Hoang Thi Thu Ha, Pham Hoang Giang, Nguyen Thi To Uyen (Author)
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