[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-448019-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-448019-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","injectable-testosterone-replacement-therapy-within-1-year-before-acl-reconstruction-is-associated-with-increased-revision-rates","Injectable Testosterone Replacement Therapy Within 1 Year Before ACL Reconstruction Is Associated With Increased Revision Rates","","The study evaluates whether preoperative injectable testosterone replacement therapy (TRT) is associated with increased revision surgery after anterior cruciate ligament reconstruction (ACLR). Using a retrospective cohort from 2015–2022 in the PearlDiver Database, preoperative TRT exposure within 1 year showed a significantly higher ACLR revision rate than matched controls (17.05% vs 5.17%; P\u003C.001). Distant exposure was underpowered, while any perioperative exposure showed no significant difference. The analysis supports a ~3-fold increase in revision risk with recent injectable TRT.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & 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was the purpose of the study?","Question",{"text":62,"@type":63},"To evaluate the association between preoperative injectable TRT and ACLR revision surgery, testing whether revision rates are higher with preoperative TRT compared with a matched cohort.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How was the study conducted?",{"text":67,"@type":63},"A retrospective cohort of ACLR patients from 2015–2022 was identified in the PearlDiver Database, with TRT exposure defined by diagnosis and procedure code-based criteria and compared using propensity score matching and comorbidity adjustment.",{"name":69,"@type":60,"acceptedAnswer":70},"What did the results show about TRT timing?",{"text":71,"@type":63},"Injectable TRT within 1 year before primary ACLR was associated with a higher revision rate (17.05%) versus matched controls (5.17%), while any exposure before or after surgery showed similar revision rates without statistical significance.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},448019,1790899430,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & 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Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":111,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":33,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":111,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":117},4398048949847,"https://ap-avatar.wpscdn.com/avatar/400002536579ef2da7f?_k=1778318612642679267","Original Research  \nInjectable Testosterone Replacement Therapy Within 1 Year Before ACL Reconstruction Is Associated With Increased Revision Rates  \nMichael William Stickels,* y BS , Brett Brazier, z DO, Romir Parmar, y BS  , Austin Cronen, y BS, Clayton Hui, y BS, and Anup Shah, z MD, MBA Investigation performed at Banner University Medical Center, Orthopaedic Sports Medicine Department, Phoenix, Arizona, USA  \n\n| Background: It has been demonstrated that exogenous testosterone can lead to higher rates of tendinous rupture and that injectable testosterone replacement therapy (TRT) is associated with more systemic complications. While this is the case, there are few studies exploring associations between injectable TRT and complications after anterior cruciate ligament reconstruction (ACLR) surgery.\u003Cbr>Purpose/Hypothesis: The purpose of this study is to evaluate the association between preoperative injectable TRT and ACLR revision surgery. It was hypothesize that ACLR revision surgery rates will be higher in patients undergoing TRT preoperatively compared with a matched cohort.\u003Cbr>Study Design: Cohort study; Level of evidence, 3 .\u003Cbr>Methods: A retrospective cohort of patients who underwent ACLR between 2015 and 2022 was obtained through the PearlDiver Database (Mariner) . Patients with a history of ACLR, 2 years of follow-up, and injectable TRT use before ACLR were identified using International Classification of Diseases, 10th Revision, and Current Procedural Terminology codes. Three TRT usage intervals were analyzed to evaluate ACLR revision rates in those with usage of injectable TRT compared with those with propensity score–matched demographics and Charlson Comorbidity Index with no history of injectable TRT use who underwent ACLR. Cohorts were via univariate analysis, chi-square tests, Student t tests, and log-rank tests.\u003Cbr>Results: TRT use 􀀂1 year before primary ACLR surgery demonstrated a 17.05%(66/387; mean age, 40.3) ACLR revision rate compared with 5.17%(20/387; mean age, 40.8) in the matched cohort control group (P \\ .001), yielding a relative risk of revision surgery of 3.30 (95% CI, 2.04-5.33) . Statistical analysis for distant TRT use .1 year before surgery (n = 160) was underpowered but supported trends toward increased revision risk with TRT exposure with a 14.38% revision rate (n = 23) . TRT users with any exposure before or after surgery (n = 2614) had similar revision rates (n = 168; 6.36%) compared with the control group (n = 164; 6.21%); the difference was not significant (P = .82) .\u003Cbr>Conclusion: Our study demonstrated that injectable TRT use within 1 year of primary ACLR is associated with a .3-fold increase in ACLR revision rates with 2 years of follow-up. Physicians should consider incorporating this increased risk into patient counseling during shared decision-making discussions, as this correlation may influence clinical and surgical decision making for patients with previous ACLR.\u003Cbr>Keywords: testosterone replacement therapy; ACL reconstruction; graft; ACLR revision |  |\n| --- | --- |\n| Anterior cruciate ligament (ACL) injuries are one of the most common knee injuries in young active patients,\u003Cbr>The Orthopaedic Journal of Sports Medicine, 14(1), 23259671251399845 DOI: 10.1177/23259671251399845\u003Cbr>􀀂 The Author(s) 2026 | accounting for approximately 200,000 injuries in the United States per year.9,14 ACL reconstruction (ACLR) is a vital procedure for those patients who wish to return to high-level pivoting and cutting sports. Traditionally, ACLR is a successful procedure with an overall revision rate of \\ 5% at 2 years of follow-up. Of those who undergo |\n\nThis open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by-nc-nd/4.0/](licenses/by-nc-nd/4.0/)), which permits the noncommercial use, distribution, and reproductio","cbCaibMlNxWj5kXz","https://ap.wps.com/l/cbCaibMlNxWj5kXz","pdf",375670,"English","# Background\n# Purpose/Hypothesis\n# Study Design\n# Methods\n# Results\n# Conclusion\n# Keywords","[{\"question\":\"What was the purpose of the study?\",\"answer\":\"To evaluate the association between preoperative injectable TRT and ACLR revision surgery, testing whether revision rates are higher with preoperative TRT compared with a matched cohort.\"},{\"question\":\"How was the study conducted?\",\"answer\":\"A retrospective cohort of ACLR patients from 2015–2022 was identified in the PearlDiver Database, with TRT exposure defined by diagnosis and procedure code-based criteria and compared using propensity score matching and comorbidity adjustment.\"},{\"question\":\"What did the results show about TRT timing?\",\"answer\":\"Injectable TRT within 1 year before primary ACLR was associated with a higher revision rate (17.05%) versus matched controls (5.17%), while any exposure before or after surgery showed similar revision rates without statistical significance.\"}]","Injectable Testosterone Replacement Therapy Within 1 Year Before ACL Reconstruction Is Associated With Increased Revision Rates | PDF",1790724747]