Postoperative cognitive dysfunction after total joint replacement in the elderly: A meta-analysis

This meta-analysis consolidated the research on post-operative cognitive dysfunction (POCD) following total joint arthroplasty (TJA). Data from 17 studies that assessed cognition preand postsurgery in TJA patients alone (15 studies) or matched TJA and control groups (2 studies) were analysed. Results were grouped by cognitive domain (memory, attention, language, speed, general cognition) and follow-up interval (pre-discharge, 3-6 months post-surgery). The TJA data revealed small declines in reaction time and general cognition pre-discharge, but no evidence of decline 3-6 months post-surgery. Very limited TJA and Control data indicated no group differences in the changes to performance over time; however, the TJA group was cognitively compromised preand post-surgery compared to Controls. Further appropriately controlled research is required to clarify whether POCD commonly occurs after TJA.