These blood tests should be completed in the morning when testosterone levels tend to be the highest. This includes two separate blood tests to measure your testosterone levels. The first step is to review your health history and perform a workup to determine if your testosterone levels are low enough to require treatment. Together, we will create a comprehensive treatment plan to meet your needs and help you build strength, improve bone health, and get you back to the things you love. Likewise, the distribution of graft types was not significantly different between the groups, but previous studies have shown that graft type may influence outcomes of ACL repair.5,33,52 Furthermore, postoperative imaging of the graft was not performed. It is also necessary to consider that a higher dose of testosterone supplementation may achieve greater physiological effects while maintaining safety. The lack of adverse events suggests that testosterone administration at 200 mg/wk may be safe in young, healthy men undergoing surgery. As testosterone is a potent hormone acting on various organ systems, side effects and safety of the intervention were paramount concerns. Effect of testosterone on the change in strength of the uninjured leg from baseline. Baseline lean mass was measured at 2 weeks before surgery and normalized to 0. Line plot of testosterone levels at 2 weeks before surgery; 1 day before surgery; and 2, 6, 12, and 24 weeks after surgery. Intramuscular testosterone has been shown to increase muscle mass and strength, independent of exercise, and could conceivably prevent muscle loss after surgical reconstruction of the ACL.8,45,54 This study was not powered to detect differences in strength or clinical outcome scores to assess the incidence of testosterone-related adverse events. Prior studies have shown that preoperative rehabilitation may improve muscle strength and postoperative outcomes. Major exclusion criteria included previous surgery to the affected knee or concomitant injuries to the posterior cruciate ligament and collateral ligaments. The data presented in this study are available on request from the corresponding author due to the data being part of a restricted nationwide insurance dataset. Additional research must be conducted to elucidate the temporal relationship between TRT dosing and surgical outcomes. Regardless, these results may assist shoulder surgeons when evaluating patients on TRT who also seek treatment for degenerative osteoarthritis, differing degrees of rotator cuff arthropathy, or severe forms of impingement. This study queried the database in order to identify the patient cohorts, including patients undergoing RSA, and those that received TRT. To our knowledge, there are no current studies that investigate the effect of TRT on patients undergoing RSA. One study demonstrated an increased risk of prosthetic joint infection following any form of total shoulder arthroplasty (TSA) in patients who were on TRT . While there is established research on the basic science of the musculoskeletal system, there remains a paucity of literature on the effect of TRT on the clinical outcomes of orthopedic shoulder surgeries . Given the prevalence of transgender individuals who may be on TRT during the perioperative period of an orthopedic procedure, understanding the proper management of these patients is important.
