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Cleri NA, Zhang J, Singh G, Mikell CB, Pendleton C. Thoracic Intervertebral Disc Herniation Associated With Chronic Anabolic Androgenic Steroid Use: A Case Report. Cureus 2024; 16:e62438. [PMID: 39011187 PMCID: PMC11249193 DOI: 10.7759/cureus.62438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2024] [Indexed: 07/17/2024] Open
Abstract
Anabolic androgenic steroids (AAS) are relatively cheap and accessible medications, commonly used by athletes and bodybuilders for performance enhancement and muscle growth stimulation. AAS usage has been associated with musculoskeletal injuries, such as tendon and ligament ruptures, and numerous other detrimental health effects. Despite these risks, individuals continue to self-administer these drugs in supraphysiologic doses. Here, we present a case of a male bodybuilder with chronic AAS use who developed a spinal thoracic intervertebral disc herniation requiring decompression and fusion. We use this case to highlight a severe potential risk associated with chronic AAS abuse and review the current literature on the biochemical, physical, and physiologic mechanisms linking chronic AAS use, weight-bearing exercise, and the risk of musculoskeletal injuries such as intervertebral disc herniations.
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Affiliation(s)
| | - Jason Zhang
- Neurosurgery, Stony Brook University, Stony Brook, USA
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Meghani O, Albright JA, Testa EJ, Arcand MA, Daniels AH, Owens BD. Testosterone Therapy Is Associated With Increased Odds of Quadriceps Tendon Injury. Clin Orthop Relat Res 2024; 482:175-181. [PMID: 37404114 PMCID: PMC10723858 DOI: 10.1097/corr.0000000000002744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/24/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Anabolic steroid use at supraphysiologic doses has been associated with an increased risk of tendon injury. However, the musculoskeletal effects of testosterone therapy in the clinical setting are not well understood. QUESTIONS/PURPOSES (1) Is prescription testosterone associated with a higher odds of subsequent quadriceps muscle or tendon injury? (2) Is prescription testosterone associated with a higher odds of surgical repair of the quadriceps tendon? METHODS The PearlDiver Database, which contains data on Medicaid, Medicare, and commercially insured patients, allows for a large representative sample of the US population including both publicly and privately insured patients. The database was queried for all patients between 2011 and 2018 who filled a testosterone prescription. Additionally, all quadriceps injuries using ICD-9 and ICD-10 codes between 2011 and 2018 were queried. Propensity score matching based on age, sex, Charlson comorbidity index, and specific comorbidities allowed us to create matched control groups. We used the t-test and chi-square analysis to compare the unmatched and matched cohorts. A total of 151,797 patients (123,627 male patients and 28,170 female patients) with a history of filled testosterone prescriptions were included in the study after matching with the control group, which was of equal size and representation of age, male-female proportions, and comorbidities. Chi-square and logistic regression analyses were performed to compare odds of quadriceps injury and quadriceps tendon repair among the testosterone groups to that of their respective control groups by age and sex. RESULTS Within 1 year of filling prescriptions for testosterone, 0.06% (97 of 151,797) of patients experienced a quadriceps injury compared with less than 0.01% (18 of 151,797) of patients in the control group (OR 5.4 [95% CI 3.4 to 9.2]; p < 0.001). Within the sex-specific matched groups, filling a testosterone prescription was associated with an increase in the odds of quadriceps injury in male patients within 1 year of the prescription (OR 5.8 [95% CI 3.5 to 10.3]; p < 0.001). Additionally, patients who filled a testosterone prescription were at increased risk of having quadriceps tendon repair within a year of the injury than were patients in the matched control group (OR 4.7 [95% CI 2.0 to 13.8]; p = 0.001). CONCLUSION Considering these findings, it is important for physicians to counsel patients receiving testosterone replacement therapy of the substantially increased odds of quadriceps tendon injury. Future investigations into the mechanisms of influence of exogenous anabolic steroids on tendon injury remains of interest. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- Ozair Meghani
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - J. Alex Albright
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Edward J. Testa
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Michel A. Arcand
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Alan H. Daniels
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Brett D. Owens
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
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Abumunaser I, Salawati E, Albogami S, Alzahrani T, Kabouha Q, Alzahrani J, Almalki A, Alzahrani N. Knowledge and Awareness About Anabolic-Androgenic Steroid Use as a Body Shape Enhancer and Its Side Effects Among Adult Gym Participants in Jeddah, Saudi Arabia. Cureus 2024; 16:e51747. [PMID: 38318561 PMCID: PMC10840593 DOI: 10.7759/cureus.51747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Anabolic steroids, often referred to as anabolic-androgenic steroids, are steroidal androgens that include testosterone and other naturally occurring androgens, as well as synthetic androgens that are chemically linked to testosterone and have similar actions. MATERIAL AND METHODS A cross-sectional study was conducted to evaluate the knowledge and awareness about anabolic-androgenic steroid (AAS) use and its side effects among adult gym participants in Jeddah. A total of 269 adults fulfilling the inclusion criteria were included. The questionnaire covered the demographics, attitudes, and behaviors associated with AAS use and consisted of single-response questions and four multiple-response questions. All statistical methods used were two-tailed with an alpha level of 0.05, considering significance if the p-value was less than or equal to 0.05. The overall awareness score was categorized as "poor" if the students' score was less than 60% of the overall score and "good" if the students' score was 60% or more. Descriptive analysis was done by prescribing frequency distributions and percentages for study variables, including the adult's personal data, reasons for going to the gym, and duration. RESULTS This study shows a prevalence of 6.3% of adults' use of AAS, which was higher than in some regions in Saudi Arabia. The largest age group that uses AAS, according to this study, is 26-45 years old. A total of 185 (68.8%) were males, and a total of 185 (68.8%) were university graduates. The most reported reasons for going to the gym included fitness (63.2%), muscle building (52.8%), entertainment (39.4%), and weight loss (37.9%). 94.4% of people think that anabolic steroids are harmful to the body, and 80.3% know that misuse of anabolic steroids may lead to problems with the kidneys and liver. 75.1% of male adults and 76.8% of university graduates had good knowledge and awareness. The internet is the most common source of information. CONCLUSION Our study provides clear evidence that there is a high awareness of AAS and its side effects and a high prevalence of its use among male gym participants in Jeddah. The use of AAS is a national problem that the authorities need to act on. There is a strong need for health policy reforms to reduce the rise of AAS use among young adults.
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Affiliation(s)
- Ibrahim Abumunaser
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Emad Salawati
- Family Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Sultan Albogami
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Taher Alzahrani
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Qusai Kabouha
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Jamaan Alzahrani
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Abdulmajeed Almalki
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Nawaf Alzahrani
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Albright JA, Lou M, Rebello E, Ge J, Testa EJ, Daniels AH, Arcand M. Testosterone replacement therapy is associated with increased odds of Achilles tendon injury and subsequent surgery: a matched retrospective analysis. J Foot Ankle Res 2023; 16:76. [PMID: 37950322 PMCID: PMC10638827 DOI: 10.1186/s13047-023-00678-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Prescription of testosterone replacement therapy (TRT) has increased in the United States in recent years, and though anabolic steroids have been associated with tendon rupture, there is a paucity of literature evaluating the risk of Achilles tendon injury with TRT. This study aims to evaluate the associative relationship between consistent TRT, Achilles tendon injury, and subsequent surgery. METHODS This is a one-to-one matched retrospective cohort study utilizing the PearlDiver database. Records were queried for patients aged 35-75 who were prescribed at least 3 consecutive months of TRT between January 1, 2010 and December 31, 2019. Achilles tendon injuries and subsequent surgeries were identified using ICD-9, ICD-10, and CPT billing codes. Multivariable logistic regression was used to compare odds of Achilles tendon injury, Achilles tendon surgery, and revision surgery, with a p-value < 0.05 representing statistical significance. RESULTS A sample of 423,278 patients who filled a TRT prescription for a minimum of 3 consecutive months was analyzed. The 2-year incidence of Achilles tendon injury was 377.8 (95% CI, 364.8-391.0) per 100,000 person-years in the TRT cohort, compared to 245.8 (95% CI, 235.4-256.6) in the control (p < 0.001). The adjusted analysis demonstrated TRT to be associated with a significantly increased likelihood of being diagnosed with Achilles tendon injury (aOR = 1.24, 95% CI, 1.15-1.33, p < 0.001). Of those diagnosed with Achilles tendon injury, 287/3,198 (9.0%) of the TRT cohort subsequently underwent surgery for their injury, compared to 134/2,081 (6.4%) in the control cohort (aOR = 1.54, 95% CI, 1.19-1.99, p < 0.001). CONCLUSIONS There is a significant association between Achilles tendon injury and prescription TRT, with a concomitantly increased rate of undergoing surgical management. These results provide insight into the risk profile of TRT and further research into the science of tendon pathology in the setting of TRT is an area of continued interest.
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Affiliation(s)
- J Alex Albright
- Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA.
| | - Mary Lou
- Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Elliott Rebello
- Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Jonathan Ge
- Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Edward J Testa
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, 02912, USA
| | - Alan H Daniels
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, 02912, USA
| | - Michel Arcand
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, 02912, USA
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Lee E, Stillson QA, Seidel HD, Bhattacharjee S, Koh JL, Strelzow JA, Shi LL. Surgical Outcomes, Trends, and Risk Factors of Distal Triceps Repairs. Hand (N Y) 2023; 18:1300-1306. [PMID: 35658641 PMCID: PMC10617476 DOI: 10.1177/15589447221095114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Distal triceps ruptures are rare, and complete ruptures are commonly treated with surgery. Studies of patients in small cohorts with distal triceps tear have reported outcomes and risk factors; however, large-scale data are scant. This study seeks to determine current trends, outcomes, and risk factors of distal triceps tears. METHODS Within a large insurance claims database, distal triceps repair patients were identified through Current Procedural Terminology coding with concomitant distal triceps International Classification of Diseases, 9th Revision/10th Revision diagnosis codes and 1-year active status before and after surgery. Demographics, total costs, 90-day complications, and revision rates within 1 year of index surgery were analyzed. Logistic regression was performed for revision and complication rates using sex, age, and comorbidities (anabolic steroid use, diabetes, ischemic heart disease, tobacco use, rheumatoid arthritis, and chronic kidney disease). RESULTS A total of 8143 patients were included in the cohort. Male patients and patients aged 40 to 59 years comprised most of the study population. The postoperative complication rate was 5.8%, and the 1-year revision rate was 2.6%. Male sex, age >60 years, ischemic heart disease, rheumatoid arthritis, and chronic kidney disease were statistically significant risk factors for higher 90-day complication rates. Anabolic steroid use significantly increased the risk of surgical revision. CONCLUSIONS Distal triceps repairs in this large cohort study occur most frequently in men aged 40 to 59 years. Complications are generally low, with age >60 years, male sex, ischemic heart disease, rheumatoid arthritis, and chronic kidney disease as risk factors for 90-day complications and prior anabolic steroid use as a risk factor for 1-year revision surgery. This information can help to improve education and expectations of this procedure.
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Affiliation(s)
| | - Quinn A. Stillson
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Henry D. Seidel
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Jason L. Koh
- NorthShore University HealthSystem, Evanston, IL, USA
| | - Jason A. Strelzow
- Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, IL, USA
| | - Lewis L. Shi
- Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, IL, USA
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Rebello E, Albright JA, Testa EJ, Alsoof D, Daniels AH, Arcand M. The use of prescription testosterone is associated with an increased likelihood of experiencing a distal biceps tendon injury and subsequently requiring surgical repair. J Shoulder Elbow Surg 2023; 32:1254-1261. [PMID: 36918119 DOI: 10.1016/j.jse.2023.02.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/25/2023] [Accepted: 02/04/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND In the United States, the use of testosterone therapy has increased over recent years. Anabolic steroid use has been associated with tendon rupture, although there is a paucity of evidence evaluating the risk of biceps tendon injury (BTI) with testosterone therapy. The aim of this study was to quantify the risk of BTI after the initiation of testosterone therapy. METHODS This was a retrospective cohort study using the PearlDiver database. Records between 2011 and 2018 were queried to identify patients aged 35-75 years who filled a testosterone prescription for a minimum of 3 months. A control group was created, comprising patients aged 35-75 years who had never filled a prescription for exogenous testosterone. International Classification of Diseases, Ninth Revision, International Classification of Diseases, Tenth Revision, and Current Procedural Terminology codes were used to identify patients with distal biceps injuries and those undergoing surgical repair. Three matching processes were completed: one for the overall cohort, one for the cohort comprising only male patients, and one for the cohort comprising only female patients. Each cohort was matched to its control on age, sex, Charlson Comorbidity Index, diabetes, tobacco use, and osteoporosis. Multivariate logistic regression was used to compare rates of distal BTI and subsequent surgical repair in the testosterone groups with their control groups. RESULTS A total of 776,974 patients had filled a prescription for testosterone for a minimum of 3 consecutive months. In the overall matched analysis between the testosterone and control groups (n = 291,610 in both), the mean age of the patients was 53.9 years and 23.1% were women. Within 1 year of filling exogenous testosterone prescriptions for a minimum of 3 consecutive months, 650 patients experienced a distal BTI compared with 159 patients in the control group (odds ratio [OR], 4.10; 95% confidence interval [CI], 3.45-4.89; P < .001). At any time after testosterone therapy, patients with testosterone use were more than twice as likely to experience a distal BTI as their matched controls (OR, 2.07; 95% CI, 1.94-2.38). Patients who filled prescriptions for testosterone were more likely to undergo surgical repair within a year of the injury compared with the control group. A similar trend was seen in the cohort comprising male patients (OR, 1.63; 95% CI, 1.29-2.07). CONCLUSION Patients with prior prescription testosterone exposure have an increased rate of BTI and biceps tendon repair compared with patients without such exposure. This finding provides insight into the risk profile of testosterone therapy, and doctors should consider counseling patients about this risk, particularly male patients.
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Affiliation(s)
- Elliott Rebello
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, USA.
| | - J Alex Albright
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Edward J Testa
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Daniel Alsoof
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Alan H Daniels
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Michel Arcand
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, USA
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Testa EJ, Albright JA, Hartnett D, Lemme NJ, Daniels AH, Owens BD, Arcand M. The Relationship Between Testosterone Therapy and Rotator Cuff Tears, Repairs, and Revision Repairs. J Am Acad Orthop Surg 2023; 31:581-588. [PMID: 36745691 DOI: 10.5435/jaaos-d-22-00554] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 12/29/2022] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION The purpose of this study was to evaluate rates of rotator cuff tears (RCTs), repairs (RCRs), and revision RCR in patients who were prescribed testosterone replacement therapy (TRT) and compare these patients with a control group. METHODS The PearlDiver database was queried for patients who were prescribed testosterone for at least 90 days between 2011 and 2018 to evaluate the incidence of RCTs in this population. A second analysis evaluated patients who sustained RCTs using International Classification of Diseases, 9th/10th codes to evaluate these patients for rates of RCR and revision RCR. Chi square analysis and multivariate regression analyses were used to compare rates of RCTs, RCR, and subsequent or revision RCR between the testosterone and control groups, with a P -value of 0.05 representing statistical significance. RESULTS A total of 673,862 patients with RCT were included for analysis, and 9,168 of these patients were prescribed testosterone for at least 90 days before their RCT. The TRT group had a 3.6 times greater risk of sustaining an RCT (1.14% versus 0.19%; adjusted odds ratio (OR) 3.57; 95% confidence interval (CI) 3.57 to 3.96). A 1.6 times greater rate of RCR was observed in the TRT cohort (TRT, 46.4% RCR rate and control, 34.0% RCR rate; adjusted OR 1.60; 95% CI 1.54 to 1.67). The TRT cohort had a 26.7 times greater risk of undergoing a subsequent RCR, irrespective of laterality, within 1 year of undergoing a primary RCR when compared with the control group (TRT, 47.1% and control, 4.0%; adjusted OR 26.4; 95% CI 25.0 to 27.9, P < 0.001). CONCLUSIONS There is increased risk of RCTs, RCRs, and subsequent RCRs in patients prescribed testosterone. This finding may represent a musculoskeletal consequence of TRT and is important for patients and clinicians to understand. Additional research into the science of tendon injury in the setting of exogenous anabolic steroids remains of interest. LEVEL OF EVIDENCE Level Ⅲ, retrospective cohort study.
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Affiliation(s)
- Edward J Testa
- From the Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI
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Vignali JD, Pak KC, Beverley HR, DeLuca JP, Downs JW, Kress AT, Sadowski BW, Selig DJ. Systematic Review of Safety of Selective Androgen Receptor Modulators in Healthy Adults: Implications for Recreational Users. J Xenobiot 2023; 13:218-236. [PMID: 37218811 PMCID: PMC10204391 DOI: 10.3390/jox13020017] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/24/2023] Open
Abstract
Selective Androgen Receptor Modulators (SARMs) are not FDA approved, and obtaining SARMs for personal use is illegal. Nevertheless, SARM use is increasingly popular amongst recreational athletes. Recent case reports of drug-induced liver injury (DILI) and tendon rupture raise serious concerns for the safety of recreational SARM users. On 10 November 2022 PubMed, Scopus, Web of Science, and ClinicalTrials.gov were searched for studies that reported safety data of SARMs. A multi-tiered screening approach was utilized, and any study or case report of generally healthy individuals exposed to any SARM was included. Thirty-three studies were included in the review with 15 case reports or case series and 18 clinical trials (total patients N = 2136 patients, exposed to SARM N = 1447). There were case reports of drug-induced liver injury (DILI) (N = 15), Achilles tendon rupture (N = 1), rhabdomyolysis (N = 1), and mild reversible liver enzyme elevation (N = 1). Elevated alanine aminotransferase (ALT) was commonly reported in clinical trials in patients exposed to SARM (mean 7.1% across trials). Two individuals exposed to GSK2881078 in a clinical trial were reported to have rhabdomyolysis. Recreational SARM use should be strongly discouraged, and the risks of DILI, rhabdomyolysis, and tendon rupture should be emphasized. However, despite warnings, if a patient refuses to discontinue SARM use, ALT monitoring or dose reduction may improve early detection and prevention of DILI.
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Affiliation(s)
- Jonathan D. Vignali
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Kevin C. Pak
- Department of Gastroenterology, Naval Medical Center San Diego, San Diego, CA 92134, USA
| | - Holly R. Beverley
- Gorgas Memorial Library, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Jesse P. DeLuca
- Clinical Pharmacology Fellowship, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - John W. Downs
- Department of Toxicology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Adrian T. Kress
- Clinical Pharmacology Fellowship, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Brett W. Sadowski
- Department of Gastroenterology, Naval Medical Center San Diego, San Diego, CA 92134, USA
| | - Daniel J. Selig
- Clinical Pharmacology Fellowship, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
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Stefanou N, Karamanis N, Bompou E, Vasdeki D, Mellos T, Dailiana ZH. Pectoralis major rupture in body builders: a case series including anabolic steroid use. BMC Musculoskelet Disord 2023; 24:264. [PMID: 37016399 PMCID: PMC10071695 DOI: 10.1186/s12891-023-06382-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 03/29/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Rupture of the pectoralis major (PM) muscle is a rare injury, with increasing incidence over the last decades, mainly due to participation in weightlifting and contact sports. Surgical management of PM injuries has been related with superior functional outcome, faster return to activities, better cosmesis and higher level of patients' satisfaction. The aim of the study is to present our experience in the management of this rare clinical entity and to correlate the use of anabolic steroids in the occurrence of the injury and the impact of type of injury, method of reconstruction and anabolic steroids on the post-operative outcome. CASES We present a series of six male bodybuilding athletes who sustained PM rupture during weightlifting. We recorded the location & type of injury, the history and type of anabolic steroids use, the method of repair and the post-operative outcome. TREATMENT AND OUTCOMES The mean follow-up period was 16 (12-24) months. All patients treated surgically had excellent results according to Bak criteria and returned to full activity within 5.4 (5-7) months following surgical reconstruction. No post-operative complications were recorded, despite the continued use of anabolic steroids, however one patient died from myocardial infarction within a year of surgical treatment. CONCLUSIONS PM rupture is an injury with increasing incidence within bodybuilding athletes probably not related to the dominance of the limb. Fixation of the tendon with suture anchors results in excellent clinical outcome and patient's satisfaction postoperatively regardless the chronicity of the repair. Our observations in these cases suggest that anabolic steroids use may contribute to the injury due to an excessive upward adjustment of the athlete's goals in lifting weights and moreover the continuation of administration even in the recovery period does not seem to have a negative effect either on the time or on the level of adequate functional recovery postoperatively.
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Affiliation(s)
- Nikolaos Stefanou
- Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, 3 Panepistimiou St, 41500, Biopolis, Larissa, Greece
| | - Nikolaos Karamanis
- Department of Hand, Upper Extremity Surgery and Microsurgery, IASO Thessalias, 41500, Larissa, Greece
| | - Effrosyni Bompou
- Department of General Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, 3 Panepistimiou St, 41500, Biopolis, Larissa, Greece
| | - Dionysia Vasdeki
- Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, 3 Panepistimiou St, 41500, Biopolis, Larissa, Greece
| | - Thomas Mellos
- B' Department of Orthopaedic Surgery-Sports Medicine, IASO Thessalias, 41500, Larissa, Greece
| | - Zoe H Dailiana
- Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, 3 Panepistimiou St, 41500, Biopolis, Larissa, Greece.
- Department of Hand, Upper Extremity Surgery and Microsurgery, IASO Thessalias, 41500, Larissa, Greece.
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Ritsch M, Regauer M, Schoch C. [Surgical treatment of distal triceps tendon ruptures]. OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE 2022; 34:438-446. [PMID: 36094541 DOI: 10.1007/s00064-022-00781-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/21/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Restoration of the anatomy and the original length of the muscle-tendon unit in triceps tendon ruptures. INDICATIONS Acute and chronic triceps tendon ruptures with persisting symptoms and significant strength deficits. CONTRAINDICATIONS Infections and tumors in the surgical area. SURGICAL TECHNIQUE Prone position. Skin incision over the distal triceps in a lateral direction around the olecranon. Mobilization of the tendon and débridement of the olecranon. Drilling of 2 × 2.9 mm suture anchor holes medial and lateral into the footprint of the olecranon. In addition, drilling through the olecranon 12 mm distal to the tip of the olecranon and transosseous introduction of 4 sutures. Then the suture anchors (all-suture or titanium anchors) are inserted into the drill holes. Refix the deep and superficial tendons with the anchor threads. Refix the upper tendon portions with the transosseous sutures. In the case of chronic lesions, a graft interposition is necessary. POSTOPERATIVE MANAGEMENT Dorsal 10 ° splint, then change to an orthosis fixed in 20 ° extension and passive mobility 0-30 ° flexion for 6 weeks. From the 7th week onwards, load-free, physiotherapeutically controlled increasing mobilization. Starting weight-loading from the 13th week on. Full load after 6 months. RESULTS In all, 34 male strength athletes with acute triceps tendon rupture underwent surgery using the hybrid technique described and were prospectively recorded. The MEPS‑G score averaged 94.7 points, there were no permanent limitations in mobility, and the postoperative strength ability averaged 94% of the original strength performance ability. The return to sport achieved 100%. The complication rate was 20.6%. Reconstruction of the distal triceps tendon using hybrid technology leads to very good functional results. Half of all patients complained of symptoms even before the rupture, which suggests previous damage to the distal triceps tendon caused by degeneration.
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Affiliation(s)
- Mathias Ritsch
- sportortho-ro, Schön-Klinik Vogtareuth, Luitpoldstr. 4, 83022, Rosenheim, Deutschland.
| | - Markus Regauer
- sportortho-ro, Schön-Klinik Vogtareuth, Luitpoldstr. 4, 83022, Rosenheim, Deutschland
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Johnson JW, von Stade D, Gadomski B, Easley J, Nelson B, Bisazza K, Regan D, Troyer K, Zhou T, McGilvray K. Modified Alendronate Mitigates Mechanical Degradation of the Rotator Cuff in an Osteoporotic Ovine Model. Am J Sports Med 2022; 50:3649-3659. [PMID: 36259712 DOI: 10.1177/03635465221125175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Osteoporosis is an independent risk factor for failure after arthroscopic rotator cuff repair. Since rerupture rates after rotator cuff repair are associated with decreased bone mineral density and bone microarchitecture, adaptations of biomechanical properties of the rotator cuff enthesis in patients with osteoporosis remain unclear. Additionally, the effects of osteogenic therapy carrier drugs used for the treatment of osteoporosis on rotator cuff structure and properties have not been previously documented. PURPOSE To investigate the changes to soft tissue biomechanics and insertional structure secondary to osteoporosis with and without an osteogenic therapy carrier (ie, modified alendronate). STUDY DESIGN Controlled laboratory study. METHODS Biomechanical, histopathological, and microcomputed tomography analyses were performed on 20 shoulders obtained from 10 osteoporotic sheep randomly allocated to modified bisphosphonate (ie, alendronate) or control (ie, osteoporotic without treatment) groups; 6 shoulders from healthy sheep were utilized for comparison purposes. RESULTS Tendons from the control group exhibited a 57% decrease in undeformed Young modulus as compared with the healthy group (P = .010). Tendons from the modified bisphosphonate treatment group exhibited a 229% increase in initial Young modulus as compared with the control group (P = .010). Marked changes within the tendon insertional organization were noted in both the control and the modified bisphosphonate treatment group samples as evidenced by increased interdigitation of the bone-mineralized fibrocartilaginous junction. The control samples exhibited a markedly paucicellular insertion, whereas the modified bisphosphonate treated tendons exhibited a hypercellular insertional region as compared with the healthy group. Both groups exhibited significantly (P < .01) decreased bone quality underlying the infraspinatus insertion, as evidenced by all microcomputed tomography outcome parameters. CONCLUSION This work illuminates changes to rotator cuff tendon secondary to osteoporosis. Specifically, it revealed decreased tendon modulus and altered insertional structure in the osteoporotic samples. Secondarily, these data revealed increases in tendon modulus accompanied by increased cellularity within the tendon insertion region after systemic modified bisphosphonate injections. CLINICAL RELEVANCE Bisphosphonate treatment may have a positive effect on the healing of the enthesis after rotator cuff repair.
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Affiliation(s)
- James W Johnson
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, Colorado, USA
| | - Devin von Stade
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, Colorado, USA
| | - Ben Gadomski
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, Colorado, USA
| | - Jeremiah Easley
- Preclinical Surgical Research Laboratory, Colorado State University, Fort Collins, Colorado, USA
| | - Brad Nelson
- Preclinical Surgical Research Laboratory, Colorado State University, Fort Collins, Colorado, USA
| | - Katie Bisazza
- Preclinical Surgical Research Laboratory, Colorado State University, Fort Collins, Colorado, USA
| | - Daniel Regan
- Flint Animal Cancer Center and Department of Microbiology, Immunology, & Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Kevin Troyer
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, Colorado, USA
| | - Tianjian Zhou
- Department of Statistics, Colorado State University, Fort Collins, Colorado, USA
| | - Kirk McGilvray
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, Colorado, USA
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12
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Beck P, Reinecke F, Polan C, Meyer HL, Schoepp C, Burggraf M, Dudda M, Mester B. [Rupture of the pectoralis major muscle in amateur athletes: a rare injury or often overlooked?]. SPORTVERLETZUNG-SPORTSCHADEN 2022; 36:155-159. [PMID: 35413736 DOI: 10.1055/a-1754-4524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION A rupture of the pectoralis major muscle is a rare injury pattern overall, but it is frequently described in athletes, particularly in weightlifting. The risk of sustaining this type of injury is present especially during the eccentric phase of muscle loading. An association between such injuries and the abuse of anabolic steroids is described in the literature, but there is no coherent evidence to support this. We report the case of a young patient with a normal habitus who suffered a humeral rupture of the pectoralis major muscle during recreational sports. There was no history of excessive weight training or use of anabolic steroids. CASE HISTORY This 33-year-old patient reported a sudden onset of left pectoral pain during training on the chest fly machine as well as a whip-like popping sound, followed by an immediate painful restriction of movement in the left arm. A clinical examination revealed a mild haematoma located on the left medial upper arm with localised tenderness and a discrete asymmetry of the contour of the pectoral muscles. Due to the typical medical history, we established the indication for surgical exploration although the clinical picture was rather discrete and only an incomplete rupture was seen in an MRI scan. Intraoperatively, we detected a complete rupture of the sternocostal part of the pectoralis major muscle with marked retraction and haematoma. Reinforcement and reinsertion were performed at the "footprint" using titanium anchors (2 x 5.5mm Corkscrew FT, Arthrex, Florida). The patient was able to resume his sports activities at the pre-traumatic level four months after surgery. CONCLUSION A rupture of the insertion of the pectoralis major muscle must also be considered in amateur athletes with a typical history. The characteristic clinical symptoms described in the literature mostly refer to competitive athletes and bodybuilders, but these injuries can also be diagnosed in amateur athletes with lower muscle mass by subtle clinical examination. Nevertheless, there is a considerable risk of underestimating the extent of the injury. In case of doubt, surgical exploration should be performed promptly in amateur athletes. Surgical refixation of the humeral rupture of the pectoralis major muscle is the gold standard and should not be reserved to high-performance athletes.
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Affiliation(s)
- Paula Beck
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Essen, GERMANY
| | - Felix Reinecke
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Essen, GERMANY
| | - Christina Polan
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Essen, GERMANY
| | - Heinz-Lothar Meyer
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Essen, GERMANY
| | - Christian Schoepp
- Klinik für Arthroskopische Chirurgie, Sporttraumatologie und Sportmedizin, BG Klinikum Duisburg, Duisburg, GERMANY
| | - Manuel Burggraf
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Essen, GERMANY
| | - Marcel Dudda
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Essen, GERMANY
| | - Bastian Mester
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Essen, GERMANY
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13
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Anabolic Androgenic Steroids in Orthopaedic Surgery: Current Concepts and Clinical Applications. J Am Acad Orthop Surg Glob Res Rev 2022; 6:01979360-202201000-00001. [PMID: 34982051 PMCID: PMC8735789 DOI: 10.5435/jaaosglobal-d-21-00156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/05/2021] [Indexed: 12/24/2022]
Abstract
Despite the well-documented effects of testosterone and its synthetic derivatives—collectively termed anabolic androgenic steroids (AASs)—on the musculoskeletal system, the therapeutic use of these agents has received limited investigation within the field of orthopaedic surgery. In the last 2 decades, preclinical and clinical research has started to identify promising applications of the short-term use of AASs in the perioperative period. There is evidence to suggest that AASs may improve postoperative recovery after anterior cruciate ligament reconstruction and total joint arthroplasty. In addition, AASs may augment the biological healing environment in specific clinical scenarios including muscle injury, fracture repair, and rotator cuff repair. Current literature fails to present strong evidence for or against the use of AASs in orthopaedics, but there is continuous research on this topic. The purpose of this study was to provide a comprehensive overview of the current status of AAS applications in orthopaedic surgery, with an emphasis on preclinical data, clinical studies, and future directions.
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14
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Ritsch M. Bizeps- und Trizepssehnenrupturen im Kraftsport. ARTHROSKOPIE 2021. [DOI: 10.1007/s00142-021-00486-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Wang F. Theoretical Studies of Some Androgenic-Anabolic Steroid Molecules by Computational Chemistry. RUSSIAN JOURNAL OF PHYSICAL CHEMISTRY A 2021. [DOI: 10.1134/s003602442108029x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Medvedchikov AE, Anastasieva EA, Kulyaev DA, Kirilova IA. [Rehabilitation of patients after surgical treatment of avulsion rupture of the distal biceps brachial tendon]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2021; 98:53-59. [PMID: 34223755 DOI: 10.17116/kurort20219803153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Avulsion subcutaneous rupture of the distal tendon of the biceps brachial is a relatively rare occurrence. In the context of postoperative treatment, there are isolated references to rehabilitation therapists and sports physicians in the literature. However, the popularization of sports among the general population forces specialists to face this problem in clinical practice. The objective of the presented study was to review our own concept of rehabilitation in the early and late postoperative periods using the example of a specific clinical case of surgical treatment using fixation with a cortical button and an interference screw in trauma in a professional athlete. A group of surgeons and rehabilitation therapists focused their efforts on returning the patient to normal amplitudes of movements in the joints of the injured limb the ability to endure previous loads without pain in the shortest possible time without fear of relapse. The results obtained during the treatment of a sports-organized patient with an avulsion rupture of the distal tendon of the biceps brachial made it possible to question the success of the previous «immobilization» concepts broadened the professional understanding of the possibilities of modern rehabilitation allowed surgeons and rehabilitation therapists to come close to developing a universal rehabilitation protocol form.
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Affiliation(s)
- A E Medvedchikov
- Tsivyan Ya.L. Novosibirsk Research Institute of Traumatology and Orthopedics, Novosibirsk, Russia
| | - E A Anastasieva
- Tsivyan Ya.L. Novosibirsk Research Institute of Traumatology and Orthopedics, Novosibirsk, Russia
| | - D A Kulyaev
- Tsivyan Ya.L. Novosibirsk Research Institute of Traumatology and Orthopedics, Novosibirsk, Russia
| | - I A Kirilova
- Tsivyan Ya.L. Novosibirsk Research Institute of Traumatology and Orthopedics, Novosibirsk, Russia
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17
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Greif DN, Huntley SH, Alidina S, Muñoz J, Huntley JH, Greditzer HG, Jose J. MRI findings of chronic distal tendon biceps reconstruction and associated post-operative findings. Skeletal Radiol 2021; 50:1095-1109. [PMID: 33236235 DOI: 10.1007/s00256-020-03676-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/29/2020] [Accepted: 11/15/2020] [Indexed: 02/02/2023]
Abstract
Rupture of the distal biceps tendon is becoming increasingly diagnosed due to an active aging population and an increase in diagnostic imaging opportunities. While physical exam may help in diagnosis, magnetic resonance imaging (MRI) is particularly useful in evaluating chronic rupture. Although partial tears can be managed conservatively, the gold standard treatment for a chronic distal biceps tear is anatomic reinsertion with additional use of an allograft or autograft. No study has highlighted the normal appearance and postsurgical complications seen on MRI associated with allograft or autograft usage. Clinicians and radiologists may be unaware of the normal and abnormal post-operative imaging findings and their clinical relevance. The purpose of this manuscript is to discuss the epidemiology, clinical presentation, and preoperative MRI findings of distal biceps ruptures necessitating reconstruction, to explain distal biceps tendon surgical reconstruction technique with allograft or autograft usage, to display the normal and abnormal post-operative MRI findings, and to review the clinical outcomes associated with the procedure.
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Affiliation(s)
- Dylan N Greif
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA.,Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - Samuel H Huntley
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA.,Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - Sameer Alidina
- University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Julianne Muñoz
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA.,Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | | | - Harry G Greditzer
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA
| | - Jean Jose
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA. .,Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA. .,Department of Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
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18
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Gould HP, Hawken JB, Duvall GT, Hammond JW. Asynchronous Bilateral Achilles Tendon Rupture with Selective Androgen Receptor Modulators: A Case Report. JBJS Case Connect 2021; 11:01709767-202106000-00015. [PMID: 33835995 DOI: 10.2106/jbjs.cc.20.00635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 36-year-old male competitive powerlifter sustained asynchronous bilateral Achilles tendon ruptures after using 2 types of selective androgen receptor modulators (SARMs). Both tendon ruptures occurred near the myotendinous junction and were treated with open surgical repair and an initial period of immobilization followed by progressive weightbearing and rehabilitation; no postoperative complications were observed. CONCLUSION Previous studies have reported that anabolic androgenic steroids have a deleterious impact on tendon structure and function. This case suggests that SARM compounds may also predispose users to Achilles tendon rupture.
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Affiliation(s)
- Heath P Gould
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland
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19
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Tatem AJ, Holland LC, Kovac J, Beilan JA, Lipshultz LI. Nandrolone decanoate relieves joint pain in hypogonadal men: a novel prospective pilot study and review of the literature. Transl Androl Urol 2020; 9:S186-S194. [PMID: 32257859 PMCID: PMC7108994 DOI: 10.21037/tau.2019.11.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Testosterone is an archetypal androgenic-anabolic steroid (AAS), while its exogenous administration is considered to be the gold standard for the treatment of male hypogonadism. The benefits are not due to its intrinsic nature alone but are due to the result of its interactions with the androgen receptor (AR). As the management of hypogonadism continues to advance into the modern era, it would be preferable for modern andrologists to have multiple tools at their disposal to influence AR activity. Nandrolone, or 19-nortestosterone, is one such compound. In the following review of the literature, we examine the history, pharmacology, and clinical applications of this medication. We also present the results of our novel pilot study examining the favorable effects of nandrolone on joint pain for hypogonadal men.
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Affiliation(s)
| | - Levi C Holland
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Jason Kovac
- Men's Health Center, Urology of Indiana, Greenwood, IN, USA
| | | | - Larry I Lipshultz
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
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20
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Vil VA, Terent'ev AO, Savidov N, Gloriozova TA, Poroikov VV, Pounina TA, Dembitsky VM. Hydroperoxy steroids and triterpenoids derived from plant and fungi: Origin, structures and biological activities. J Steroid Biochem Mol Biol 2019; 190:76-87. [PMID: 30923015 DOI: 10.1016/j.jsbmb.2019.03.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/18/2019] [Accepted: 03/23/2019] [Indexed: 01/10/2023]
Abstract
Hydroperoxides (R-OOH) represent a small family of natural metabolites that have been isolated from higher plants, fungi, and marine organisms. This paper is devoted to the distribution of hydroperoxides in plants, fungi and terrestrial fungal endophytes and their biological activity. Hydroperoxides of plants demonstrate a wide range of biological activities however, antineoplastic and anti-ulcerative are most characteristic with confidence from 91 to 98 percent. For hydroperoxides from fungi, the dominant are antineoplastic and anti-hypercholesterolemic activities with confidence from 89 to 92 percent. Very interesting activity was found for some triterpenoid hydroperoxides, which is characterized as a treatment for the symptoms of dementia. The norlupane hydroperoxide shows activity for the treatment of dementia. It is interesting that the reliability of this activity was very high 97.2%. According to our preliminary data, the norlupane hydroperoxide is apparently the first natural metabolite that showed almost 100 percent activity for the treatment of dementia. However, to confirm these data requires practical and clinical experimental work.
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Affiliation(s)
- Vera A Vil
- N.D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991, Moscow, Russia
| | - Alexander O Terent'ev
- N.D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991, Moscow, Russia
| | - Nick Savidov
- Centre for Applied Research and Innovation, Lethbridge College, 3000 College Drive South Lethbridge, AB, T1K 1L6, Canada
| | | | | | - Tatyana A Pounina
- Far Eastern Geological Institute, Russian Academy of Sciences, 159 Prospect 100-letiya Vladivostoka, Vladivostok, 690022, Russia
| | - Valery M Dembitsky
- N.D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991, Moscow, Russia; Centre for Applied Research and Innovation, Lethbridge College, 3000 College Drive South Lethbridge, AB, T1K 1L6, Canada; National Scientific Center of Marine Biology, 690041, Vladivostok, Russia.
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21
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Santana Oliveira AJ, Batista e Silva LL, Barin FR, Leite Pereira EC, Selistre-de-Araujo HS, de Cássia Marqueti R. Detraining and Anabolic-Androgenic Steroid Discontinuation Change Calcaneal Tendon Morphology. J Funct Morphol Kinesiol 2018; 4:jfmk4010001. [PMID: 33467316 PMCID: PMC7739234 DOI: 10.3390/jfmk4010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/14/2018] [Accepted: 12/19/2018] [Indexed: 11/16/2022] Open
Abstract
Several side effects of anabolic-androgenic steroid (AAS) administration associated with training are reported in the biomechanical properties of the calcaneal tendon (CT) of rats. Thus, the aim of the present study is to evaluate the effects of the detraining and discontinuation of AAS administration on the CT morphology of rats submitted to exercise in water. Animals were divided into two groups (20/group): (1) Immediately after training (IA), and (2) Six weeks of detraining and AAS discontinuation (6W). The IA group included four subgroups: Sedentary (S), Trained (T), Sedentary with AAS administration (SAAS), and trained with AAS administration (TAAS). The 6W group included four subgroups: Sedentary (6W-S), six weeks of detrained (6W-T), six weeks of sedentary with AAS discontinuation (6W-SAAS), and six weeks of detrained with AAS discontinuation (6W-TAAS). Data show significant reduction in adipose cells volume density (Vv%) in the distal CT in 6W-TAAS group, indicating that training can exert a positive effect on the tendon. The 6W-SAAS group exhibited increased adipose cells Vv% in the distal region, compared with the W6-S and W6-T groups. A decrease in tendon proper cells Vv% and in peritendinous sheath cells Vv% of proximal and distal regions was also observed. In 6W-TAAS group showed increase in adipose cells, blood vessels, peritendinous sheath cells, and tendon proper cells Vv% in the distal region of the CT. The vertical jumps in water were not able to protect CT regions from the negative effects of AAS discontinuation for six weeks. However, after detraining and AAS discontinuation, many protective factors of the mechanical load in the long-term could be observed.
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Affiliation(s)
| | | | | | | | | | - Rita de Cássia Marqueti
- Faculty of Ceilândia, University of Brasília, Brasília, DF 72220-275, Brazil
- Correspondence: ; Tel.: +55-61-3107-8419
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22
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Guzzoni V, Selistre-de-Araújo HS, Marqueti RDC. Tendon Remodeling in Response to Resistance Training, Anabolic Androgenic Steroids and Aging. Cells 2018; 7:E251. [PMID: 30544536 PMCID: PMC6316563 DOI: 10.3390/cells7120251] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 11/30/2018] [Accepted: 11/30/2018] [Indexed: 12/14/2022] Open
Abstract
Exercise training (ET), anabolic androgenic steroids (AAS), and aging are potential factors that affect tendon homeostasis, particularly extracellular matrix (ECM) remodeling. The goal of this review is to aggregate findings regarding the effects of resistance training (RT), AAS, and aging on tendon homeostasis. Data were gathered from our studies regarding the impact of RT, AAS, and aging on the calcaneal tendon (CT) of rats. We demonstrated a series of detrimental effects of AAS and aging on functional and biomechanical parameters, including the volume density of blood vessel cells, adipose tissue cells, tendon calcification, collagen content, the regulation of the major proteins related to the metabolic/development processes of tendons, and ECM remodeling. Conversely, RT seems to mitigate age-related tendon dysfunction. Our results suggest that AAS combined with high-intensity RT exert harmful effects on ECM remodeling, and also instigate molecular and biomechanical adaptations in the CT. Moreover, we provide further information regarding the harmful effects of AAS on tendons at a transcriptional level, and demonstrate the beneficial effects of RT against the age-induced tendon adaptations of rats. Our studies might contribute in terms of clinical approaches in favor of the benefits of ET against tendinopathy conditions, and provide a warning on the harmful effects of the misuse of AAS on tendon development.
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Affiliation(s)
- Vinicius Guzzoni
- Departamento de Biologia Molecular e Celular, Universidade Federal da Paraíba, João Pessoa 58051-970, Paraíba, Brazil.
| | | | - Rita de Cássia Marqueti
- Graduate Program of Rehabilitation Science, University of Brasilia, Distrito Federal, Brasília 70840-901, Distrito Federal, Brazil.
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