Effects of Melatonin on Sleep Quality and Patient-Reported Outcomes After Arthroscopic Rotator Cuff Surgery: A Prospective Randomized Controlled Trial.
OrthoEvidence Journal (OE Journal) - ACE Report
Epub Ahead of Print
Am J Sports Med. 2024 01-Oct;():. 10.1177/03635465241272076What this means for my practice?
Melatonin supplementation after arthroscopic rotator cuff repair may improve early postoperative sleep quality and later functional outcomes while reducing narcotic use, which may be a useful additional therapy to enhance recovery. Clinically, melatonin may represent a low-risk intervention to support multimodal postoperative care and reduce reliance on opioids. Key limitations include reliance on patient-reported adherence and lack of objective measures such as tear size, which could influence recovery outcomes.
Study Summary
Eighty patients with rotator cuff tears undergoing arthroscopic rotator cuff repair were randomized to receive oral melatonin 5 mg nightly or standard sleep hygiene recommendations alone. The primary outcome of interest was sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes of interest included shoulder function measured by the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), and postoperative narcotic consumption. Outcomes were assessed preoperatively and at 2 weeks, 6 weeks, 3 months, 4 months, and 6 months postoperatively. Overall, the results of the study revealed significantly improved PSQI scores at 6 weeks, improved ASES and SANE functional outcomes at later postoperative time points, and reduced narcotic use at 4 months in the melatonin group. These findings suggest that melatonin may enhance early sleep recovery and contribute to improved functional outcomes following arthroscopic rotator cuff repair.
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