Postoperative Pain, Total Knee Arthroplasty
Conditions
Keywords
virtual reality, distraction technique, postoperative pain, total knee arthroplasty, nursing intervention
Brief summary
This randomized controlled trial evaluates the effectiveness of three distraction techniques-virtual reality (VR) headset, squishy (squeeze toy), and poetry reading-on postoperative pain control in adults undergoing total knee arthroplasty. Participants are randomized into four parallel groups (three intervention arms and one usual care control). Pain intensity is assessed using the Visual Analog Scale (VAS), with primary assessment at 24 hours after surgery.
Detailed description
Total knee arthroplasty is a common orthopedic procedure that can be associated with significant postoperative pain. In addition to standard pharmacological analgesia, non-pharmacological approaches such as distraction techniques may help reduce perceived pain by redirecting attention away from nociceptive stimuli. This single-center, parallel-group randomized controlled trial will be conducted in the Orthopedics and Traumatology Clinic of Osmaniye State Hospital in Türkiye. Eligible adults (≥18 years) undergoing total knee arthroplasty will be randomized using a stratified block randomization approach based on baseline pain severity (VAS 0-3, 4-6, 7-10) to ensure balanced allocation across groups. The intervention arms include (1) VR headset distraction, (2) use of a squishy (squeeze toy) as a tactile distraction method, and (3) poetry reading as a cognitive distraction method. The control group receives usual postoperative care without a structured distraction intervention. All groups follow the same postoperative analgesia protocol. The primary outcome is postoperative pain intensity measured by VAS at 24 hours after surgery.
Interventions
BEHAVIORALVR Distraction
A supervised virtual reality distraction session delivered via a VR headset during postoperative hospitalization to support non-pharmacological pain management.
BEHAVIORALTactile Distraction With Squishy
Use of a squishy (squeeze toy) as a tactile distraction technique during postoperative hospitalization as part of non-pharmacological pain management.
BEHAVIORALPoetry Reading Distraction
Structured poetry reading conducted during postoperative hospitalization as a cognitive distraction approach to support non-pharmacological pain management.
Sponsors
Izmir Tinaztepe University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 years or older * Undergoing total knee arthroplasty * Hospitalized in the postoperative period at Osmaniye State Hospital * Able to communicate and complete pain assessment (Visual Analog Scale) * Provides written informed consent * Managed under the same postoperative analgesia protocol and operated by the same surgeon (as per study protocol)
Exclusion criteria
* Severe cognitive impairment or inability to provide valid pain assessment * Postoperative complications that may interfere with participation or pain assessment * Contraindication to the assigned distraction method (e.g., intolerance to wearing a VR headset, severe nausea/dizziness, claustrophobia) * Refusal or withdrawal of consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain Intensity (VAS) | 24 hours after surgery | Visual Analog Scale pain score (0=no pain, 10=worst pain). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain Intensity (VAS) by Pain Severity Strata | 24 hours after surgery | VAS pain score analyzed by baseline pain strata (0-3, 4-6, 7-10) using stratified allocation groups. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORSongül Gungor
Osmaniye State Hospital
STUDY_DIRECTORBerna Dizer
Izmir Tinaztepe University
Outcome results
None listed