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

Background: Anxiety and depression are known risk factors for poor prognosis after arthroscopic rotator cuff repair (ARCR). However, studies that examine relief of postoperative psychological distress in patients with anxiety and/or depression remain limited. Purpose: To evaluate the effect of duloxetine on the clinical outcomes of ARCR for chronic rotator cuff tears in patients with anxiety and/or depression. Study Design: Randomized controlled clinical trial; Level of evidence, 2. Method: A total of 63 patients undergoing ARCR were enrolled and categorized into 3 groups based on Hospital Anxiety and Depression Scale (HADS) scores and the use of oral duloxetine: group A (anxiety .05). Functional outcomes and retear rates did not differ among the 3 groups at later follow-up. Conclusion: Administration of duloxetine to ARCR patients with anxiety and/or depressive distress screened using HADS not only improved anxiety and distress but also enhanced active ROM, ASES, and SST in the first 3 months postoperatively, although 16% of patients experienced nausea and vomiting.