{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T19:08:12Z","timestamp":1779476892642,"version":"3.53.1"},"reference-count":47,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Korean Orthopeadic Pain Society"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the effect of duloxetine on the clinical outcomes of ARCR for chronic rotator cuff tears in patients with anxiety and\/or depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Randomized controlled clinical trial; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>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 &lt;8 and depression &lt;8, healthy psychological status; n = 20); group B (anxiety \u22658 and\/or depression \u22658, psychological distress receiving duloxetine administration; n = 21); and group C (anxiety \u22658 and\/or depression \u22658, psychological distress receiving no duloxetine treatment; n = 22). Duloxetine was administered orally from the evening of the surgery. The dosage was 30 mg\/d for the first 2 weeks. After the adaptation period, the dosage was increased to 60 mg\/d for 12 weeks. Primary outcome was active forward flexion at postoperative 3 months. Other functional outcomes, structural outcomes, analgesic consumption, and duloxetine-related side effects were assessed at postoperative 3, 6, and 12 months and annually thereafter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      No severe adverse events related to duloxetine were observed. However, 16% (4\/25) of patients in group B experienced nausea and vomiting after duloxetine administration. Although symptoms resolved completely after antiemetic intervention, the patients withdrew from the study due to the drug-related adverse event. In the first 3 months after surgery, group B showed better range of motion (ROM), better functional outcomes (American Shoulder and Elbow Surgeons Standardized Assessment Form [ASES] and Simple Shoulder Test [SST]), better anxiety scores, better pain scores, and less opioid consumption than did group C (all adjusted\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05). These differences were not observed between groups A and B (all adjusted\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; .05). Functional outcomes and retear rates did not differ among the 3 groups at later follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465261430918","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T12:30:12Z","timestamp":1775305812000},"page":"1333-1343","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8506-6328","authenticated-orcid":false,"given":"Sheng Chen","family":"Han","sequence":"first","affiliation":[{"name":"Center for Rehabilitation Medicine, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6257-8882","authenticated-orcid":false,"given":"Jian","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou University, Huzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8073-5434","authenticated-orcid":false,"given":"Young Ki","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Konyang University Hospital, Daejeon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2418-4257","authenticated-orcid":false,"given":"Ji Won","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8406-0750","authenticated-orcid":false,"given":"Hyeon Jang","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National 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