In total, 189 patients were included, with 84 receiving perioperative testosterone and 105 receiving placebo or a control intervention. One study investigated patients undergoing elective anterior cruciate ligament reconstruction. One study evaluated patients undergoing elective total knee arthroplasty. Demographic data, surgical indications, details of testosterone use, and outcomes were recorded and analyzed. Three reviewers independently screened all titles, abstracts, and full texts of articles investigating perioperative testosterone use in orthopaedic surgery.
The database was queried for all patients who underwent RSA with at least two years of follow-up. Since PearlDiver is a deidentified database, this study was exempt from institutional review board approval. The PearlDiver database contains Humana Insurance claims data for more than 150 million patients and tracks the patients over time using diagnosis and procedure. A retrospective cohort study was conducted using the PearlDiver Mariner database (PearlDiver Technologies, Colorado Springs, CO, USA) from 2010 to 2022.
Common markers of endocrine function were monitored for all participants because of the potential for systemic side effects of testosterone. Eighty-six patients were screened, and 14 participants enrolled in the study. Except for the pharmacist and statistician, all persons involved were blinded to the treatment assignment, including the surgeon, investigators, study team, physical therapist, and patients. Patients with a cartilage injury representing full-thickness loss down to bone were also excluded. Men aged 18 to 50 years who presented with clinically diagnosed acute ACL insufficiency were screened for eligibility. The primary outcome was the change in total lean body mass at 6 and 12 weeks.
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Baseline extension torque was measured at 2 weeks before surgery and normalized to 0. At 12 and 24 weeks postoperatively, there were no significant between-group differences in LH and FSH levels. Eight patients received an autograft for ACL reconstruction (6 hamstring, 2 bone–patellar tendon–bone), while 5 patients were repaired using allografts (4 semitendinosus, 1 bone–patellar tendon–bone). Of the 13 patients enrolled in the study, 6 underwent repair for meniscal tears. An a priori power analysis was performed using nQuery Version 4 (Stasols) to estimate the number of participants needed to find a statistically significant difference in lean mass. The TAS was also administered at each study visit to determine preinjury physical activity levels.