Patients on testosterone replacement therapy may have increased risk for ACL injury
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Key takeaways:
- Testosterone replacement therapy may be a risk factor for ACL injury.
- The increased risk of injury may be a consequence of the physiological changes induced by testosterone, according to researchers.
Patients using testosterone replacement therapy for at least 3 months may have an increased risk for ACL injuries, according to recently published data.
Joseph C. Brinkman, MD, orthopedic surgery resident at the Mayo Clinic in Arizona, and colleagues performed a retrospective comparison study of data from 160,839 patients who were prescribed testosterone replacement therapy (TRT) and filled two or more testosterone prescriptions for at least 3 months. Brinkman and colleagues compared outcomes with a 1:1 matched control cohort of 160,839 patients who were not using TRT.
According to the study, 87.2% of participants in the study were male patients with an average age of 50.4 years. Overall, 60.6% of patients in the TRT cohort and 5.9% of patients in the control cohort were diagnosed with hypogonadism.
Researchers found 572 patients (0.35%) in the TRT cohort and 157 patients (0.1%) in the control cohort had experienced an ACL injury within 2 years (OR = 2.77). The overall incidence of ACL injury was 17.8 per 10,000 person-years for the TRT cohort and 4.9 per 10,000 person-years for patients in the control group.
Brinkman and colleagues found patients younger than 25 years had significantly higher rates of ACL tears compared with other age groups (OR = 3.91-12.3). In addition, male patients in the TRT cohort were 3.13 times more likely to have an ACL injury vs. male patients in the control group, while female patients in the TRT cohort were 1.94 times more likely to have an ACL injury vs. female patients in the control group.
“This association may be a consequence of the physiological changes induced by TRT that the clinician should be aware of and remains an area of ongoing interest,” Brinkman and colleagues wrote in the study.
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