Nandrolone Decanoate and Load Increase Remodeling and Strength in Human Supraspinatus Bioartificial Tendons

Background: To date, no studies document the effect of anabolic steroids on rotator cuff tendons. Study Design: Controlled laboratory study. Hypothesis: Anabolic steroids enhance remodeling and improve the biomechanical properties of bioartificially engineered human supraspinatus tendons. Methods: Bioartificial tendons were treated with either nandrolone decanoate (nonload, steroid, n = 18), loading (load, nonsteroid, n = 18), or both (load, steroid, n = 18). A control group received no treatment (nonload, nonsteroid [NLNS], n = 18). Bioartificial tendons’ remodeling was assessed by daily scanning, cytoskeletal organization by staining, matrix metalloproteinase–3 levels by ELISA assay, and biomechanical properties by load-to-failure testing. Results: The load, steroid group showed the greatest remodeling and the best organized actin cytoskeleton. Matrix metallo-proteinase–3 levels in the load, steroid group were greater than those of the nonload, nonsteroid group ( P < .05). Ultimate stress and ultimate strain in the load, steroid group were greater than those of the nonload, nonsteroid and nonload, steroid groups ( P < .05). The strain energy density in the load, steroid group was greater when compared to other groups ( P < .05). Conclusions: Nandrolone decanoate and load acted synergistically to increase matrix remodeling and biomechanical properties of bioartificial tendons. Clinical Relevance: Data suggest anabolic steroids may enhance production of bioartificial tendons and rotator cuff tendon healing in vitro. More research is necessary before such clinical use is recommended. Keywords: anabolic steroids supraspinatus tendon mechanical loading material properties bioartificial tendons