ArticleSports health
Initiating Testosterone Therapy Without Indication for Treatment of Low Testosterone Is Associated With Higher Risk of Tendon Tear.
Article in Sports health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- 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
- Testosterone Therapy and Associated Rates of Tendon Tear and Surgical Repair: A Retrospective Analysis.Orthopaedic journal of sports medicine · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies have demonstrated an increasing rate of testosterone supplementation in patients who do not meet criteria for testosterone deficiency, but the risks associated with testosterone supplementation are unclear. HYPOTHESIS: Patients initiating testosterone therapy would be diagnosed with significantly more tendon tears and undergo significantly more tendon repairs than matched controls never on testosterone therapy. STUDY
designCohort study. LEVEL OF EVIDENCE: Level 3.
methodsMale patients who initiated testosterone therapy within 30 days of a primary care visit and who did not meet criteria for treatment of low testosterone were identified (n = 112,242). Propensity score matching generated a control cohort (n = 448,968) with no history of testosterone therapy and based on several comorbidities at the time of said age-matched primary care visit. Rates of tendon tears and tendon repairs within 1 and 2 years after primary care visit were compared using multivariable logistic regression.
resultsWithin 1 and 2 years, compared with controls, the testosterone supplementation cohort demonstrated significantly higher rates of rotator cuff tear (odds ratio [OR], 1.35; OR, 1.31), patellar tendon tear (OR, 2.06; OR, 2.14), and any tendon tear (OR, 1.33; OR, 1.31). The testosterone supplementation cohort demonstrated significantly higher rates of quadriceps tendon tears within 1 year (OR, 1.59). Within 1 and 2 years, compared with controls, the testosterone supplementation cohort demonstrated significantly higher rates of rotator cuff repair (OR, 1.28; OR, 1.23), distal biceps tendon repair (OR, 1.65; OR, 1.54), patellar tendon repair (OR, 2.28; OR, 2.18), and any tendon repair (OR, 1.27; OR, 1.23).
conclusionTestosterone supplementation is associated with an increased risk of tendon tears and repairs for at least the first and second year after initiating therapy in patients with no documented laboratory testing. Patients considering testosterone therapy should be counseled on this increased risk of tendon injury.
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