{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:10:55Z","timestamp":1788887455541,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"133","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To investigate the effect of combining conventional rehabilitation nursing with targeted noise control during the key sleep period on clinical outcomes in elderly patients with knee osteoarthritis (KOA) after knee arthroplasty.\n                    <jats:bold>Methods:<\/jats:bold>\n                    This retrospective study included 100 elderly patients with KOA who underwent knee arthroplasty at the Orthopedics Department of the Second Affiliated Hospital of Zhejiang University School of Medicine, between May 2023 and September 2024. According to the actual nursing records and ward noise management implemented during hospitalization, patients were divided into a control group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200950), which received conventional orthopedic rehabilitation nursing and routine noise control, and an observation group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200950), which received conventional orthopedic rehabilitation nursing plus additional targeted nighttime noise control during key sleep period. Propensity score matching was used to exclude baseline confounding. The incidence and duration of postoperative delirium, Sedation-Agitation Scale (SAS) scores, ward noise levels (\n                    <jats:italic toggle=\"yes\">L<\/jats:italic>\n                    <jats:sub>Aeq<\/jats:sub>\n                    ,\n                    <jats:italic toggle=\"yes\">L<\/jats:italic>\n                    <jats:sub>Amax<\/jats:sub>\n                    ), and Richards\u2013Campbell Sleep Questionnaire (RCSQ) scores were compared between the two groups.\n                    <jats:bold>Results:<\/jats:bold>\n                    The observation group showed a significantly lower postoperative delirium incidence and a shorter duration of delirium than the control group (both\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05). During the key sleep period (02:00\u201304:00), both\n                    <jats:italic toggle=\"yes\">L<\/jats:italic>\n                    <jats:sub>Aeq<\/jats:sub>\n                    and\n                    <jats:italic toggle=\"yes\">L<\/jats:italic>\n                    <jats:sub>Amax<\/jats:sub>\n                    values were significantly lower in the observation group (both\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05). The observation group also had lower SAS scores and higher RCSQ scores (both\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05). Moreover, postoperative recovery was superior in the observation group, as reflected by earlier first out-of-bed mobilization, greater knee flexion at discharge, and a shorter length of hospital stay (all\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05).\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    In this retrospective study, conventional orthopedic rehabilitation nursing combined with targeted nighttime noise control during key sleep periods was significantly associated with a lower incidence of postoperative delirium, better sleep quality, and faster functional recovery in elderly patients after knee arthroplasty.\n                  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Arthroplasty"],"prefix":"10.4103","volume":"28","author":[{"given":"LiHong","family":"Lai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HuanTing","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JiaJiang","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GuoPing","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"R1-20260908","first-page":"e32256","article-title":"Effects of intra-articular platelet rich plasma on cartilage thickness, clinical and functional outcomes in knee 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