Aim: To examine the effectiveness of music as an adjunct treatment for pain, anxiety, and/or postoperative delirium, for patients undergoing hip or knee surgery.

Background: Patients undergoing hip or knee surgery are known to experience pain and anxiety before and after surgery and be prone to postoperative delirium.

Design: Quantitative systematic review.

Data Sources: CENTRAL, Embase, Ovid MEDLINE, CINAHL, and PsycINFO databases were systematically searched without time limits (to June 2018).

Review Methods: A systematic search yielded 10 randomized controlled trials and quasi‐experimental designs. Studies were appraised using the Cochrane Risk of Bias Tool. Data were extracted using the Effective Practice and Organization of Care data extraction tool.

Results: Mixed results were found for the effect of music on anxiety, pain, and postoperative delirium in patients undergoing hip or knee surgery. Six of 10 included studies provided evidence that music can improve anxiety, pain, or postoperative delirium outcomes for patients undergoing hip or knee surgery. Music effectively reduced anxiety in one of three studies. Three of seven studies reported benefits of music for reducing postoperative pain. Positive effects of music on postoperative delirium were reported in all three studies that evaluated this outcome. Within group improvements were observed in many of the studies.

Conclusion: Music has the potential to improve outcomes of anxiety, pain, and postoperative delirium, for patients undergoing hip or knee surgery. The low number of studies found indicates results should be treated with caution. Further studies are required to provide strong evidence generalizable to a broader population.