ArticleJournal of foot and ankle research2023
Testosterone replacement therapy is associated with increased odds of Achilles tendon injury and subsequent surgery: a matched retrospective analysis.
Article in Journal of foot and ankle research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- Pre-operative injectable testosterone therapy is associated with increased five-year revision risk after total shoulder arthroplasty: a TriNetX database analysis.Journal of shoulder and elbow arthroplasty · 2026Article
- Testosterone Therapy and Tendon Injury: Clinical Evidence, Biological Mechanisms, and Sports Medicine Implications.Cureus · 2026Review
- Article
- Sex Hormones & Exercise in the Musculoskeletal System: From Signaling to Structure and Function.Endocrine reviews · 2026Article
- The relationship between testosterone replacement therapy and incidence of proximal humerus fractures in men: a matched retrospective analysis.JSES reviews, reports, and techniques · 2026Article
- Testosterone Therapy and Associated Rates of Tendon Tear and Surgical Repair: A Retrospective Analysis.Orthopaedic journal of sports medicine · 2026Article
- Preoperative testosterone replacement therapy: a potential risk-factor for complications and reoperation after rotator cuff repair.JSES international · 2026Article
- Injectable Testosterone Replacement Therapy Within 1 Year Before ACL Reconstruction Is Associated With Increased Revision Rates.Orthopaedic journal of sports medicine · 2026Article
- Chronic nonsteroidal anti-inflammatory drug use is associated with increased risk of distal biceps tendon injury.JSES international · 2025Article
- Testosterone Replacement Therapy Is Not Associated with Greater Revision Rates in Reverse Total Shoulder Arthroplasty.Journal of clinical medicine · 2025Article
- The Relationship Between Exogenous Testosterone Use and Risk for Primary Anterior Cruciate Ligament Rupture.Orthopaedic journal of sports medicine · 2024Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrescription of testosterone replacement therapy (TRT) has increased in the United States in recent years, and though anabolic steroids have been associated with tendon rupture, there is a paucity of literature evaluating the risk of Achilles tendon injury with TRT. This study aims to evaluate the associative relationship between consistent TRT, Achilles tendon injury, and subsequent surgery.
methodsThis is a one-to-one matched retrospective cohort study utilizing the PearlDiver database. Records were queried for patients aged 35-75 who were prescribed at least 3 consecutive months of TRT between January 1, 2010 and December 31, 2019. Achilles tendon injuries and subsequent surgeries were identified using ICD-9, ICD-10, and CPT billing codes. Multivariable logistic regression was used to compare odds of Achilles tendon injury, Achilles tendon surgery, and revision surgery, with a p-value < 0.05 representing statistical significance.
resultsA sample of 423,278 patients who filled a TRT prescription for a minimum of 3 consecutive months was analyzed. The 2-year incidence of Achilles tendon injury was 377.8 (95% CI, 364.8-391.0) per 100,000 person-years in the TRT cohort, compared to 245.8 (95% CI, 235.4-256.6) in the control (p < 0.001). The adjusted analysis demonstrated TRT to be associated with a significantly increased likelihood of being diagnosed with Achilles tendon injury (aOR = 1.24, 95% CI, 1.15-1.33, p < 0.001). Of those diagnosed with Achilles tendon injury, 287/3,198 (9.0%) of the TRT cohort subsequently underwent surgery for their injury, compared to 134/2,081 (6.4%) in the control cohort (aOR = 1.54, 95% CI, 1.19-1.99, p < 0.001).
conclusionsThere is a significant association between Achilles tendon injury and prescription TRT, with a concomitantly increased rate of undergoing surgical management. These results provide insight into the risk profile of TRT and further research into the science of tendon pathology in the setting of TRT is an area of continued interest.
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