Anabolic steroids in patients undergoing total knee arthroplasty

Area of Science:

• Orthopedics
• Pharmacology
• Rehabilitation Medicine

Background:

• Total knee replacement (TKR) is a common procedure for end-stage knee osteoarthritis.
• Postoperative rehabilitation is crucial for optimal functional recovery.
• Anabolic-androgenic steroids (AAS) have anabolic properties that may aid muscle recovery and growth.

Purpose of the Study:

• To systematically review the existing evidence on the efficacy and safety of AAS in TKR rehabilitation.
• To evaluate the impact of AAS on functional outcomes, strength, and adverse events post-TKR.

Main Methods:

• A systematic review of all available clinical study designs was conducted.
• Searches were performed across multiple databases (MEDLINE, EMBASE, AMED, CINAHL, Cochrane Library) up to August 2012.
• Inclusion criteria encompassed all study designs without language or demographic restrictions, assessing functional, physiological, and administrative outcomes, and adverse events.

Main Results:

• Two small randomized controlled trials met the inclusion criteria.
• The AAS group demonstrated statistically significant improvements in quadriceps strength, Functional Independence Measure, and Knee Society Score at various time points.
• No significant differences were found in hamstring strength, bone mineral density, sit-to-stand testing, walking speed, or hospital stay. No adverse events were reported.

Conclusions:

• Current evidence is insufficient to recommend routine AAS administration for TKR patients.
• Pilot data suggest AAS may be safely administered and could improve key postoperative outcomes.
• A sufficiently powered randomized trial is warranted to confirm clinical significance.