Survey of orthopaedic and sports medicine physicians regarding use of medrol dosepak for sports injuries.
OBJECTIVE
To study the use of a methylprednisolone taper (Medrol Dosepak; Pfizer, New York, NY) short-term oral corticosteroid treatment modality by sports medicine physicians; included is discussion on indications, perceived efficacy, and complications.


METHODS
A survey specific to Medrol Dosepak (MDP) use was mailed to all members of the Arthroscopy Association of North America (AANA) and the American Orthopedic Society for Sports Medicine (AOSSM). Surveys were collected and data were collated and analyzed.


RESULTS
Total response rate was 41% (1,290/3,167), US response rate 43% (1,247/2,906), and international response rate 16% (43/261). Prescribing of MDP for sports injuries was significantly associated with average patient age <or=40 years (chi square; P = .001), but it was not associated with years in practice or patients seen per year. It was found that 47% of members (603/1,290) prescribe MDP. Postinjury disease was the most common indication. The most frequent complication was glucose intolerance (37%; 222/603). Of members who prescribe MDP, 8.5% (51/603) reported that they had seen 101 total cases of osteonecrosis, predominantly in the hip. Results revealed that 52% of members (672/1,290) do not prescribe MDP. The most frequent reasons for not prescribing included fear of osteonecrosis (30%; 201/672), fear of complications in general (27%; 183/672), lack of proven efficacy (27%; 180/672), and fear of malpractice (4.5%; 30/672). Of nonprescribing members (171/672), 25% had seen 500 cases of osteonecrosis, most often in the hip.


CONCLUSIONS
The responding membership of AANA and AOSSM is evenly split regarding MDP use. Average patient age <or=40 years was associated with a greater likelihood that MDP would be prescribed for sports injuries. Postinjury disease is the most common indication; lack of proven efficacy and osteonecrosis are deterrents to prescription.


METHODS
Level V, expert opinion.
Langer
Phillip
P
Department of Orthopedic Surgery, Brown Medical School/Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA. langerpr@hotmail.com
Fadale
Paul
P
Hulstyn
Michael
M
Fleming
Braden
B
Brady
Mark
M
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001265:Athletic Injuries / Q000188:drug therapy*; D003625:Data Collection; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006801:Humans; D008511:Medicine; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009656:North America; D009985:Orthopedics; D012955:Societies, Medical; D013038:Specialization; D013178:Sports Medicine; D000078329:Workforce
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone