Post-Traumatic Stress Disorder Is Associated With Opioid Use Disorders Following Rotator Cuff Repair

Background Rotator cuff repair (RCR) is commonly performed to treat symptomatic rotator cuff tears, but postoperative recovery can be influenced by patient-level factors beyond structural pathology. Post-traumatic stress disorder (PTSD), a prevalent mental health condition associated with altered pain perception and substance use, may affect recovery following RCR. Methods A retrospective cohort study was conducted using the TriNetX Research Network. Adult patients undergoing RCR with PTSD were matched 1:1 to patients without PTSD based on demographics and comorbidities. Ninety-day and two-year postoperative outcomes were evaluated, and relative risks with 95% confidence intervals were calculated. Results A total of 2,262 matched patients were included per cohort. At 90 days, there were no differences in medical complications between groups. However, patients with PTSD demonstrated increased emergency department visits (16.58% vs 11.16%, RR 1.49, p < 0.001) and higher rates of sleep disorders (16.22% vs 12.76%, RR 1.27, p=0.002). The mean number of opioid prescriptions was similar (2.87 ± 2.97 vs 2.69 ± 2.39, p=0.132). Additionally, patients with PTSD were more likely to develop cannabis use disorder at 2 years (3.48% vs 1.21%, RR 2.89, p < 0.001). Conclusion PTSD is associated with sleep disorders, ED utilization, and cannabis use disorders. These findings highlight the importance of addressing psychosocial factors in postoperative recovery.