Initiating Testosterone Therapy Without Indication for Treatment of Low Testosterone Is Associated With Higher Risk...

Area of Science:

• Endocrinology
• Orthopedic Surgery
• Pharmacology

Background:

• Growing use of testosterone supplementation in individuals not meeting deficiency criteria.
• Unclear risks associated with testosterone therapy.

Purpose of the Study:

• To investigate the association between testosterone therapy and tendon tears/repairs.
• To compare outcomes in patients initiating testosterone therapy versus matched controls.

Main Methods:

• Retrospective cohort study of over 100,000 male patients initiating testosterone therapy.
• Propensity score matching used to create a control group of nearly 450,000 patients.
• Comparison of tendon tear and repair rates within 1 and 2 years using logistic regression.

Main Results:

• Significantly higher rates of rotator cuff, patellar, and quadriceps tendon tears in the testosterone group.
• Elevated rates of rotator cuff, distal biceps, and patellar tendon repairs observed.
• Increased risk of any tendon tear and repair persisted for up to two years.

Conclusions:

• Testosterone supplementation is associated with increased tendon tear and repair risk.
• This risk is evident for at least two years post-initiation in patients without documented testing.
• Counseling patients on potential tendon injury risk is crucial before therapy initiation.