Testosterone Therapy and Associated Rates of Tendon Tear and Surgical Repair: A Retrospective Analysis

Area of Science:

• Orthopedics
• Endocrinology
• Sports Medicine

Background:

• Testosterone replacement therapy (TRT) is increasingly used for men and women.
• Previous studies suggest exogenous testosterone may elevate tendon injury risk.
• Limited data exists on TRT's impact on tendon rupture rates and treatment.

Purpose of the Study:

• To examine the association between TRT and tendon rupture risk.
• To specifically analyze rotator cuff tear (RCT) incidence and treatment in TRT users.
• To compare RCT repair and revision rates between TRT users and non-users.

Main Methods:

• A retrospective cohort study analyzed electronic health records from 2015-2023.
• Patients (≥18 years) with tendon rupture and recent TRT prescription were identified using ICD-10 codes.
• Exclusion criteria removed individuals with predisposing risk factors; RCT subanalysis used chart review and propensity matching.

Main Results:

• TRT was linked to higher tendon rupture rates in men (3.6% vs 1.3%), but not women.
• Rotator cuff tears were the most common injury (77%) in TRT users.
• TRT users with RCT were more likely to receive nonoperative treatment (74.4% vs 46.7%).

Conclusions:

• TRT is associated with increased tendon rupture risk in men, possibly due to dosing differences.
• TRT users with RCT showed similar tear severity but less frequent surgical repair compared to controls.
• Further research is needed to understand sex-specific effects and optimal management strategies.