title: [Successive ruptures of patellar and Achilles tendons. Anabolic steroids in competitive sports].
abstract: Derivatives of testosterone or of 19-nor-testosterone are used as anabolics for the purpose of improving performance although the effect of anabolics is known still to be under discussion. The use of anabolic steroids continues among competitive athletes despite increased controls and increasingly frequent dramatic incidents connected with them. Whereas metabolic dysfunction during anabolic use is well documented, ruptures of the large tendons are rarely reported. Within 18 months, a 29-year-old professional footballer needed surgery for rupture of the patellar tendon and of both Achilles tendons. Carefully directed questioning elicited confirmation that he had taken different anabolic steroids regularly for 3 years with the intention of improving his strength. After each operation anabolic steroids were taken again at a high dosage during early convalescence and training. Minimally invasive surgery and open suturing techniques led to complete union of the Achilles tendons in good time. Training and anabolic use (metenolon 300 mg per week) started early after suturing of the patellar tendon including bone tunnels culminated in histologically confirmed rerupture after 8 weeks. After a ligament reconstruction with a semitendinosus tendon graft with subsequent infection, the tendon and reserve traction apparatus were lost. Repeated warnings of impaired healing if anabolic use was continued had been given without success. In view of the high number of unrecorded cases in competitive and athletic sports, we can assume that the use of anabolic steroids is also of quantitative relevance in the operative treatment of tendon ruptures.
authors: Klinik und Poliklinik für Unfall-, Hand und Wiederherstellungschirurgie, Klinikum der Universität zu Köln, Joseph-Stelzmann-Strasse 9, 50924, Köln. isenbergajem@aol.com
authors: J
authors: J
authors: Isenberg
authors: A
authors: A
authors: Prokop
authors: E
authors: E
authors: Skouras
mesh_terms: D000125:Achilles Tendon / Q000187:drug effects / Q000293:injuries; D000328:Adult; D045930:Anabolic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D004300:Doping in Sports; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000139:chemically induced / Q000188:drug therapy; D017847:Patellar Ligament / Q000187:drug effects / Q000293:injuries; D012421:Rupture / Q000139:chemically induced; D012916:Soccer / Q000293:injuries*; D013256:Steroids / Q000008:administration & dosage* / Q000009:adverse effects*; D013708:Tendon Injuries / Q000139:chemically induced* / Q000188:drug therapy*
chemical_list: D045930:Anabolic Agents; D013256:Steroids
references: J Shoulder Elbow Surg. 2004 Sep-Oct;13(5):580-2
references: 15383821
references: Br J Sports Med. 2005 May;39(5):e27
references: 15849280
references: Am J Sports Med. 2003 Nov-Dec;31(6):1007-9
references: 14623672
references: Sportverletz Sportschaden. 2000 Mar;14(1):1-11
references: 10859788
references: Unfallchirurg. 1998 Sep;101(9):731-4
references: 9816984
references: Am J Sports Med. 1984 Nov-Dec;12(6):469-84
references: 6391216
references: J Gerontol A Biol Sci Med Sci. 2005 Dec;60(12):1586-92
references: 16424293
references: Transplantation. 1994 Sep 27;58(6):736-7
references: 7940700
references: Med Sci Sports Exerc. 2006 Apr;38(4):644-51
references: 16679978
references: Curr Opin Pharmacol. 2004 Dec;4(6):614-20
references: 15525553
references: Zentralbl Chir. 1993;118(6):368-71
references: 8342346
references: Unfallchirurg. 1999 Jul;102(7):543-7
references: 10459301
references: Ther Umsch. 2001 Apr;58(4):226-31
references: 11344954