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The use of anabolic steroids in elderly patients after knee replacement could therefore have beneficial effects on postoperative development of muscle strengthas well as the development of pain after knee replacement. The study by Köhne et al. (14) included a large sample of patients aged ≥75 y with persistent knee pain after knee-replacement surgery and concluded that those treated with anabolic steroids reported significantly greater increase the daily amount of anabolic agents at a mean of 6.4% of the total amount used by these patients. This can be partly explained by increased anabolic steroid levels in the patient group, as compared to the matched controls. Similar results were also reported by a series (15) of older men and women treated with the oral anabolics, l-methionine and ethylestradiol (ETH), for at least 3 d, during which time their pain levels went down and their levels of bone mineral density went up. Moreover, these men used more agents (eg, testosterone and anabolic steroids) and longer duration of treatment than the control group and the patients treated with an anti-inflammatory medication. This could have contributed to the findings. In the present study, although the patients who received anabolic steroids experienced a significant pain reduction after knee replacement, this was not associated with improvements in bone density. Furthermore, in spite of the fact that the mean value for bone mineral density was significantly lower in patients taking anabolic steroids compared to those taking the anti-inflammatory medication used for treatment, the pain was considerably less marked at baseline and this reduced as time progressed during treatment. We speculate that, in the future, we might want to find other strategies to treat painful symptoms in older patients treated with this agent. Acknowledgments We would like to thank Dr. Pekka Laine from the University of Helsinki for his invaluable assistance in conducting this study. This study was supported by the Finnish Foundation for Research and Technolgy, the Finnish Orthopedic Society and the Finnish Scientific Research Council. Footnotes Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Similar articles:
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