Testosterone Replacement Therapy and Associated Rates of Trigger Finger, de Quervain Tenosynovitis, and Their Subsequent Management

医学 腱鞘炎 触发指 睾酮(贴片) 睾酮替代 芬克尔斯坦试验 物理疗法 外科 内科学 病理 雄激素 替代医学 激素
作者
Patrick Barhouse,James A. Albright,Elliot Rebello,Kenny Chang,Matthew Quinn,Alan H. Daniels,Michel Arcand,Joseph A. Gil
出处
期刊:The Journal of Hand Surgery [Elsevier]
卷期号:49 (6): 532-540
标识
DOI:10.1016/j.jhsa.2024.01.018
摘要

PurposeAnabolic steroid therapy has been associated with tendon injury, but there is a paucity of evidence associating physiologic testosterone replacement therapy (TRT) with tenosynovitis of the hand, specifically trigger finger and de Quervain tenosynovitis. The purpose of this study was to evaluate the relationship between TRT and tenosynovitis of the hand.MethodsThis was a one-to-one exact matched retrospective cohort study using a large nationwide claims database. Records were queried between 2010 and 2019 for adult patients who filled a prescription for TRT for 3 consecutive months. Rates of new onset trigger finger and de Quervain tenosynovitis and subsequent steroid injection or surgery were identified using ICD-9, ICD-10, and Current Procedural Terminology billing codes. Single-variable chi-square analyses and multivariable logistic regression were used to compare rates in the TRT and control cohorts while controlling for potential confounding variables. Both unadjusted and adjusted odds ratios (OR) are reported for each comparison.ResultsIn the adjusted analysis, patients undergoing TRT were more than twice as likely to develop trigger finger compared to their matched controls. TRT was also associated with an increased likelihood of experiencing de Quervain tenosynovitis. Of the patients diagnosed with either trigger finger or de Quervain tenosynovitis over the 2-year period, patients with prior TRT were roughly twice as likely to undergo steroid injections or surgical release for both trigger finger and de Quervain tenosynovitis compared to the controls.ConclusionsTRT is associated with an increased likelihood of both trigger finger and de Quervain tenosynovitis, and an increased likelihood of requiring surgical release for both conditions.Type of study/level of evidencePrognostic II.

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