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Injection of Steroid Hormones

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Orthobiologics

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Abstract

Corticosteroids have been used routinely in orthopaedics for years, mostly for their anti-inflammatory properties. While androgenic-anabolic steroids (AAS) use also dates back many decades, research regarding their therapeutic use as a biologic is not well understood. It has been demonstrated that AAS affect tendon morphology, leading to decreased tendon strength and increased tendon stiffness. Despite this, there does seem to be a beneficial role for AAS in the healing of tendon injuries. In normal rotator cuff tears, fatty degeneration, retraction, and muscle atrophy have been shown to influence disease progression and functional outcomes following repair. There appears to be a temporal relationship, with studies to date mostly demonstrating the prevention of fatty degeneration and atrophy with AAS administration immediately following tendon injury in animal models. There is also existing evidence that AAS can be effective in minimizing muscle atrophy in ACL injury and repair, as well as other orthopaedic conditions, although further research is needed to determine what this anabolic muscle effect has on recovery time and long-term outcomes. As we move forward with AAS studies in humans, there needs to be continuous evaluation of the balance between their positive effects on muscle mass and fatty degeneration and the potential negative effects on tendons, remodelling, and other organs.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keck School of Medicine of USC, University of Southern California (USC), Los Angeles, CA, USA

    Tristan W. Juhan, Andrew J. Homere, Alexander E. Weber, George F. Hatch & Frank A. Petrigliano

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  1. Tristan W. Juhan
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  2. Andrew J. Homere
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  3. Alexander E. Weber
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  4. George F. Hatch
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  5. Frank A. Petrigliano
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Correspondence to Frank A. Petrigliano .

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Editors and Affiliations

  1. Rizzoli Orthopaedic Institute, Bologna, Italy

    Giuseppe Filardo

  2. Orthopaedic & Sports Medicine Group, Santa Monica Orthopaedic & Sports Medicine, Santa Monica, CA, USA

    Bert R. Mandelbaum

  3. Orthopaedic Surgery and Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA

    George F. Muschler

  4. Hospital for Special Surgery, New York, NY, USA

    Scott A. Rodeo

  5. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan

    Norimasa Nakamura

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Juhan, T.W., Homere, A.J., Weber, A.E., Hatch, G.F., Petrigliano, F.A. (2022). Injection of Steroid Hormones. In: Filardo, G., Mandelbaum, B.R., Muschler, G.F., Rodeo, S.A., Nakamura, N. (eds) Orthobiologics. Springer, Cham. https://doi.org/10.1007/978-3-030-84744-9_7

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