RMD Open
Sleepless nights, sooner joint replacement surgery? UK study raises the question
A UK Biobank cohort study of adults with hip (n=41,737) or knee pain (n=81,958) found that among patients with knee pain, those who reported "usually" experiencing insomnia symptoms had a higher likelihood of undergoing total knee replacement within the first 4.7 years after enrollment (adjusted hazard ratio, 1.14; 95% confidence interval, 1.04–1.25) compared with those who reported "never" experiencing insomnia symptoms. This association was not seen for those who "sometimes" experienced insomnia symptoms. No relationship was found between insomnia symptoms (either "usually" or "sometimes") and total hip replacement in individuals with hip pain.
Clinical takeaway: Insomnia may be a modifiable factor in earlier knee replacement progression, and addressing sleep problems could support knee pain management, though more research is needed to determine whether treating insomnia reduces replacement risk.
Source:
Haber T, et al. Insomnia and progression to total joint replacement in hip (41 737) and knee pain (81 958): a prospective UK biobank cohort study. RMD Open. 2026. https://doi.org/10.1136/rmdopen-2025-006357
