Anabolic‐steroid therapy after geriatric proximal femur fracture: a level I evidence systematic review and meta-analysis of bone density, functional recovery, and safety
Pooled result · Hip BMD z-scoreResult — go to the resultd 1.29 95% CI 1.04–1.55Authors' conclusion
Low-dose AAS after hip fracture surgery increased BMD and improved patient-reported function without significant safety concerns.
Study context
- Population
- Geriatric patients after proximal femur (hip) fracture surgery
- Participants
- 466 patients9 randomized controlled trials (RCTs)
- Comparison
- Androgenic anabolic steroids vs placebo/standard care after hip fracture
- Androgenic anabolic steroids (AAS)n = 214
- Outcome
- Hip bone mineral density (BMD) z-score
Methodological detailsfixed-effect modeling, GRADE certainty assessment
- Fixed-effect modeling
- GRADE certainty assessment
Pooled result
As reported in the abstract
d
1.29
95% CI 1.04–1.55
Further pooled results
Harris Hip Score (HHS)
- HHS improved with anabolic therapy, d
- 2.85 (95% CI 2.52-3.17)
- Fixed-effect
- Very low certainty due to a high risk of bias and imprecision
Katz Activities of Daily Living (KADL) index
- KADL index improved with anabolic therapy, d
- 0.95 (95% CI 0.71-1.19)
- Fixed-effect
- Very low certainty due to a high risk of bias and imprecision
Operative-leg strength vs contralateral leg
- No significant gain
Safety
- Mild, transient AEs (liver-enzyme elevation, sweating, hirsutism) — AAS
- 6.1%
Serious androgen-related complications
- None reported
Original publication
Anabolic‐steroid therapy after geriatric proximal femur fracture: a level I evidence systematic review and meta-analysis of bone density, functional recovery, and safety. Osteoporos Int. Published 17 November 2025. doi:10.
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