Use of Anabolic Steroids in Patients Undergoing Total Knee Replacement: A Systematic Review
Year: 2026
Type: review
Study design: Systematic Review
Abstract: Total knee arthroplasty (TKA) is an effective surgical treatment for advanced osteoarthritis, but postoperative recovery is frequently limited by quadriceps weakness, muscle atrophy, and prolonged rehabilitation. Anabolic steroids, such as nandrolone decanoate and testosterone, have demonstrated potential benefits in enhancing muscle strength, functional mobility, and bone density. This systematic review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with PROSPERO, evaluated the efficacy and safety of anabolic steroid interventions in patients undergoing TKA. Two randomized controlled trials were identified: one assessed postoperative nandrolone administration and the other evaluated preoperative supraphysiological testosterone therapy. Both studies reported improvements in quadriceps strength, functional outcomes, and early recovery parameters, with favorable safety profiles and no major adverse events. Nandrolone was associated with higher Knee Society Scores and reduced muscle weakness over 12 months, while testosterone improved early functional independence and shortened rehabilitation needs. Although encouraging, the findings are limited by small sample sizes, variability in dosing regimens, and short follow-up durations. Larger, multicenter studies are warranted to confirm efficacy, optimize treatment protocols, and assess long-term safety. Anabolic steroids may represent a promising adjunct to rehabilitation strategies in selected TKA patients, particularly older adults at risk of poor recovery.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7204938987