Saturday, May 11, 2013

Human Growth Hormone ( HGH )( STH )( Somatotropin ) and the rotator cuff



Human Growth Hormone May Be Detrimental When Used to Accelerate Recovery from Acute Tendon-Bone Interface Injuries



A commercial website touts: "when you take into account that hormones may hold the secret to stopping aging in its tracks and that GH is the hormone produced on the largest scale in the human body, it may be our own fountain of youth."

The authors of this JBJS article point out the use of HGH by major league baseball players in the hope of facilitated healing after injury. This study was supported by a grant from Major League Baseball. We're not sure that the investigation reported answers the question, but the study is interesting. The authors tested the hypothesis that human growth hormone would accelerate tendon-to-bone healing compared with control animals treated with placebo in a rat model of acute rotator cuff injury repair.

Seventy-two rats had repair of a rotator cuff incision and repair. They were randomized to receive either placebo, or human growth hormone at 0.1, 1, 2, 5, and 10 mg/kg/day for fourteen days. Mechanical testing showed no difference with respect to  ultimate stress, ultimate force, stiffness, energy to failure, or ultimate distension of the repair.

An additional twenty-four rats were randomized to receive either (1) placebo or (2) human growth hormone at 5 mg/kg, administered twice per day for seven days preoperatively and twenty-eight days postoperatively.  In this group, ultimate force to failure was significantly worse in the human growth hormone group compared with the placebo group. Failure was more likely to occur through the bone than the tendon-bone interface in the human growth hormone group compared with the placebo group. No significant difference was found for ultimate stress, ultimate force, stiffness, energy to failure, or ultimate distension between the groups.

This study suggests that human growth hormone treatment does not identifiably accelerate the strength of tendon-to-bone healing from acute injury and may have negative biomechanical consequences.

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