Duloxetine Improves Early Clinical Outcomes Including Range of Motion, Functional Scores, Pain, and Psychological Distress After Arthroscopic Rotator Cuff Repair in Patients With Anxiety or Depression: Prospective Randomized Controlled Trial.

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Study Summary

63 patients undergoing arthroscopic rotator cuff repair for chronic rotator cuff tears were randomized into two treatment groups; psychological distress treated with duloxetine and psychological distress without duloxetine. The primary outcome of interest was active forward flexion at 3 months postoperatively. Secondary outcomes of interest included external rotation, internal rotation, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST) score, pain Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale (HADS) anxiety and depression scores, analgesic consumption, retear rate, satisfaction, and duloxetine-related adverse events. Outcomes were assessed through 3 months, 6 months, one year, and final follow-up, with pain and analgesic use also assessed in the immediate postoperative period. Overall, the results of the study revealed that duloxetine-treated patients with psychological distress had better early range of motion, functional scores, pain scores, anxiety scores, and lower opioid consumption than distressed patients who did not receive duloxetine. These findings suggest that duloxetine may help normalize early recovery after rotator cuff repair in patients with anxiety and/or depressive distress.