Thread: AAS Improve Rehabilitation After Surgery

AAS Improve Rehabilitation After Surgery

Acute distal biceps rupture poses a devastating injury associated with athletes following high-resistance-training regimens. It usually occurs in the dominant extremity during excessive eccentric tension and is mainly observed in sports including high resistance and/or full body contact. Numerous articles report the benefits of different acute repair operative techniques. Regardless of incision or fixation type, the goal of any repair is to promote tendon ingrowth into bone while preventing range of motion (ROM) deficits and heterotopic ossification.

Currently there is little consensus on post-operative rehabilitation guidelines. Early active or passive ROM has been suggested to facilitate tendon reattachment into bone at the repair site with papers reporting on the safety of early active ROM after repair via single anterior incision. This helps with another problem the physician has to deal with when treating high resistance training individuals; highly variable compliance to postoperative regimens, with many of these patients returning to aggressive sports or occupational activities earlier than recommended. Recognizing this patient-specific peculiarity, we followed an immediate active ROM protocol after repair via the modified single incision repair thus helping patients regain ROM comparable to the uninjured side without deleterious effects on neither the reconstruction’s healing nor the operated extremity’s flexion and supination strength.

The fact that an increasing number of high-resistance-training individuals abuse AAS complicates treatment. AAS have a proven substantial protein anabolic effect on contractile proteins, increasing structural integrity and size of existing and/or newly regenerating muscle fibers. It has been proven that AAS enhance remodelling and improve biomechanical properties of bioartificially engineered human tendons, suggesting that they may enhance tendon-healing in vivo. Latest developments indicate that androgens are important for male bone metabolism and homeostasis, increasing radial growth via maintenance of cancellous bone mass and expansion of cortical bone. This may influence incorporation of the newly attached tendon in the radial bone but may also affect heterotopic ossification in a non-favourable manner. There is an increasing need to further delineate the effects of this kind of pharmacological agent abuse on the anatomic reconstruction of the musculotendinous injury.

The aim of this study was to observe and report all possible effects the AAS abuse patterns might have on the healing and recuperation of anatomic reconstruction of the ruptured distal biceps tendon and on heterotopic ossification, comparing these results to a similar group of surgically treated individuals.

Pagonis T, Givissis P, Ditsios K, Pagonis A, Petsatodis G, Christodoulou A. The effect of steroid-abuse on anatomic reinsertion of ruptured distal biceps brachii tendon. Injury. The effect of steroid-abuse on anatomic reinsertio... [Injury. 2011] - PubMed result

INTRODUCTION: There is an increase in the number of anabolic-steroid (AS)-abusing trainees, who suffer from sports injuries, needing reconstruction surgery. Rupture of the distal biceps brachii tendon is a common injury in this group.

PURPOSE: The study aimed to investigate the effect of AS abuse in the anatomic reconstruction of the ruptured distal biceps brachii tendon along with an immediate range-of-motion postoperative protocol.

METHODS: We conducted an observation study of 17 male athletes suffering from distal biceps tendon ruptures. Six of them reported that they abused AS (group A), whereas the non-users comprised group B (n=11). Both groups were treated with the modified single-incision technique with two suture anchors and an immediate active range-of-motion protocol postoperatively. Follow-up was at 4, 16 and 52weeks postoperatively, with a final follow-up at 24 months.

RESULTS: Follow-up at 4, 16 and 52 weeks postoperatively showed a statistical significance in favour of group A for therapeutic outcomes concerning flexion, supination, pronation, Disabilities of the Arm, Shoulder and Hand (DASH) Disability Symptom Scores, Mayo Elbow Performance Elbow Scores and isometric muscle strength tests for both flexion and supination. Twenty-four months postoperatively, statistical significance in favour of group A was recorded in isometric muscle strength tests for both flexion and supination and also in DASH Disability Symptom Score.

DISCUSSION: The results of our study suggest that there is a correlation between the effect of AS and the quicker and better recuperation and rehabilitation observed in group A. Nonetheless, these results must be interpreted with caution, and further in vivo research is needed to confirm these findings.
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Consultations. Contact Dr. Scally at mscally@alum.mit.edu or mscally@hptaxis.com. Dr. Scally has personally cared for thousands of individuals using AAS, particularly for anabolic steroid-induced hypogonadism. DONATIONS ARE NEEDED AND APPRECIATED AT ASIH HOME.
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Default Re: Anabolic Steroids (AAS) & Joints/Tendons
AAS Improve Rehabilitation After Surgery
[This is a very small sample, so take the results with some amount of care.]

Acute distal biceps rupture poses a devastating injury associated with athletes following high-resistance-training regimens. It usually occurs in the dominant extremity during excessive eccentric tension and is mainly observed in sports including high resistance and/or full body contact. Numerous articles report the benefits of different acute repair operative techniques. Regardless of incision or fixation type, the goal of any repair is to promote tendon ingrowth into bone while preventing range of motion (ROM) deficits and heterotopic ossification.

Currently there is little consensus on post-operative rehabilitation guidelines. Early active or passive ROM has been suggested to facilitate tendon reattachment into bone at the repair site with papers reporting on the safety of early active ROM after repair via single anterior incision. This helps with another problem the physician has to deal with when treating high resistance training individuals; highly variable compliance to postoperative regimens, with many of these patients returning to aggressive sports or occupational activities earlier than recommended. Recognizing this patient-specific peculiarity, we followed an immediate active ROM protocol after repair via the modified single incision repair thus helping patients regain ROM comparable to the uninjured side without deleterious effects on neither the reconstruction’s healing nor the operated extremity’s flexion and supination strength.

The fact that an increasing number of high-resistance-training individuals use AAS complicates treatment. AAS have a proven substantial protein anabolic effect on contractile proteins, increasing structural integrity and size of existing and/or newly regenerating muscle fibers. It has been proven that AAS enhance remodelling and improve biomechanical properties of bioartificially engineered human tendons, suggesting that they may enhance tendon-healing in vivo. Latest developments indicate that androgens are important for male bone metabolism and homeostasis, increasing radial growth via maintenance of cancellous bone mass and expansion of cortical bone. This may influence incorporation of the newly attached tendon in the radial bone but may also affect heterotopic ossification in a non-favourable manner. There is an increasing need to further delineate the effects of this kind of pharmacological agent abuse on the anatomic reconstruction of the musculotendinous injury.

The aim of this study was to observe and report all possible effects the AAS use patterns might have on the healing and recuperation of anatomic reconstruction of the ruptured distal biceps tendon and on heterotopic ossification, comparing these results to a similar group of surgically treated individuals.

Pagonis T, Givissis P, Ditsios K, Pagonis A, Petsatodis G, Christodoulou A. The effect of steroid-abuse on anatomic reinsertion of ruptured distal biceps brachii tendon. Injury. The effect of steroid-abuse on anatomic reinsertio... [Injury. 2011] - PubMed result

INTRODUCTION: There is an increase in the number of anabolic-steroid (AS)-abusing trainees, who suffer from sports injuries, needing reconstruction surgery. Rupture of the distal biceps brachii tendon is a common injury in this group.

PURPOSE: The study aimed to investigate the effect of AS abuse in the anatomic reconstruction of the ruptured distal biceps brachii tendon along with an immediate range-of-motion postoperative protocol.

METHODS: We conducted an observation study of 17 male athletes suffering from distal biceps tendon ruptures. Six of them reported that they abused AS (group A), whereas the non-users comprised group B (n=11). Both groups were treated with the modified single-incision technique with two suture anchors and an immediate active range-of-motion protocol postoperatively. Follow-up was at 4, 16 and 52weeks postoperatively, with a final follow-up at 24 months.

RESULTS: Follow-up at 4, 16 and 52 weeks postoperatively showed a statistical significance in favour of group A for therapeutic outcomes concerning flexion, supination, pronation, Disabilities of the Arm, Shoulder and Hand (DASH) Disability Symptom Scores, Mayo Elbow Performance Elbow Scores and isometric muscle strength tests for both flexion and supination. Twenty-four months postoperatively, statistical significance in favour of group A was recorded in isometric muscle strength tests for both flexion and supination and also in DASH Disability Symptom Score.

DISCUSSION: The results of our study suggest that there is a correlation between the effect of AS and the quicker and better recuperation and rehabilitation observed in group A. Nonetheless, these results must be interpreted with caution, and further in vivo research is needed to confirm these findings.

__________________

Consultations. Contact Dr. Scally at mscally@alum.mit.edu or mscally@hptaxis.com. Dr. Scally has personally cared for thousands of individuals using AAS, particularly for anabolic steroid-induced hypogonadism. DONATIONS ARE NEEDED AND APPRECIATED AT ASIH HOME.

Read more from the MESO-Rx Steroid Forum at: Anabolic Steroids (AAS) & Joints/Tendons - Page 5 - MESO-Rx

Is that mean, than if I am after operation on my broken ankle, the small doses test and deca will help me, to back my leg to normal?