Anabolic Steroids May Improve Surgical Repair Of Massive Or Recurrent Tears Of The Shoulder’s Rotator Cuff Tendon
Dr. Robert J. Langer, M.D., Ph.D., Professor of Surgery at the University of North Carolina School of Medicine in Chapel Hill, N.C., and colleagues recently published a study on this topic in the Journal of Bone and Joint Surgery (JBM).
Drs. Langer and David A. Karp, M.D., both are members of the Department of Orthopedic Surgery at UNC Hospitals and performed this study as part of their training program.
The researchers used a rat model to test whether administration of anabolic steroids improves surgical repair of severe shoulder tears. They found that rats treated with testosterone gel had better healing than those given saline solution. Rats receiving testosterone gel also healed faster than the control group, which was not surprising since they were injected with the steroid directly into their wounds instead of having it applied via a topical cream or ointment.
The purpose of this study was to determine whether steroids, given in a way that would be similar to their administration to humans, would improve healing of massive or recurrent rotator cuff tears. The researchers believe that the answer is yes. “If these findings are confirmed by larger studies, administration of anabolic steroids may become an important adjunct to surgical repair of these tears,” they wrote.
The next step would be to do a clinical trial in people to see if this actually does improve their healing. While it is possible that anabolic steroids could be used to improve healing of rotator cuff tears, there are several reasons why this may not happen. First, rats and people are different. Second, the type of steroid used in this study is no longer considered to be safe. Third, even “safe” steroids have many side effects, some of which may be detrimental.
Finally, even if the steroids are safe and do improve healing, there is no evidence that they would improve function.
In this study, the rats were given a relatively high dose of anabolic steroids. The researchers suggest that a future study should be done to see what dose is best. It is also possible that a “loading dose” immediately after surgery might be more beneficial than a constant, lower dose.
In conclusion, the researchers wrote that “These findings suggest that anabolic steroids may improve rotator cuff healing by enhancing tissue regeneration. Further studies are necessary to confirm these findings and to determine the most effective regimen for administration of these agents.”
This study was supported by grants from the Arthritis Foundation and the National Institutes of Health.
Efficacy of Intra-Tear Injection of Testosterone into Acute and Chronic Rotator Cuff Tears: A Rat Model Study
By Nathan D. Kim, MD; David K. Dawson, PhD; John R. Parkey, MD; and John F. Day, Jr., MD
Nathan D. Kim, David K. Dawson, John R. Parkey, and John F. Day, Jr.
have disclosed no relevant financial relationships.
The American Journal of Sports Medicine: Abstract Publication
Provided by ArmMed Media
Revision date: July 9, 2011
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