Mitochondrial Calcium Uniporter protects hippocampal CA2 neurons from NMDA-induced excitotoxic injury.

The incidence of rotator cuff repair (RCR) continues to rise, with over 500,000 procedures performed annually in the United States. Optimizing perioperative recovery is essential for controlling immediate postoperative pain, facilitating early mobilization, achieving clinically meaningful functional improvement, and sustaining pain relief over the long‐term., , Early postoperative pain can impede participation in rehabilitation and delay the restoration of shoulder function. In contrast, persistent pain is associated with reduced patient‐reported outcome scores and slower return to activity., Targeted perioperative strategies that address both acute and sustained recovery, particularly in subgroups such as patients with small and medium tears who may have the greatest capacity for rapid improvement, have the potential to improve outcomes after RCR meaningfully. Perioperative intravenous (IV) dexamethasone is a potent, long‐acting glucocorticoid with both anti‐inflammatory and antiemetic properties. In the context of shoulder surgery, it has been shown to prolong the duration of regional nerve blocks, reduce postoperative pain intensity, and decrease postoperative nausea and vomiting., , The mechanism of analgesic benefit is thought to involve suppression of inflammatory mediators and modulation of nociceptive signaling, which may extend beyond the immediate postoperative period., Randomized controlled trials and meta‐analyses have shown that dexamethasone, whether administered intravenously or perineurally, can meaningfully enhance the duration of analgesia and improve early recovery after arthroscopic shoulder procedures., , , , However, most studies have focused on early pain relief, with limited attention to patient‐centered outcomes such as achieving the minimum clinically important difference (MCID) in pain scores or exploring whether these benefits differ by rotator cuff tear size. Although perioperative IV dexamethasone has shown consistent benefits in extending regional block duration, reducing pain, and decreasing postoperative nausea and vomiting in both arthroscopic and open shoulder procedures,, , , , , , the literature is limited in evaluating its effect on longer‐term, patient‐centered outcomes following RCR. Specifically, few studies have examined whether perioperative dexamethasone increases the proportion of patients achieving a MCID in pain scores. This threshold reflects meaningful improvement from the patient's perspective, and is not clear whether these effects vary by rotator cuff tear size. Furthermore, there is a paucity of evidence assessing whether the potential benefits of dexamethasone persist beyond the immediate postoperative window to influence recovery trajectories in the early rehabilitation period. Addressing these questions may guide selective perioperative use of dexamethasone to optimize functional recovery after RCR. The purpose of this study was to evaluate the effect of perioperative dexamethasone on patient‐reported pain, functional outcomes according to tear size, and MCID achievement following arthroscopic RCR. We hypothesized that patients who receive dexamethasone would experience improved pain control and functional outcomes, which would differ according to tear size, after undergoing arthroscopic RCR compared with the control group.