Editorial Commentary: Testosterone, Growth Hormone, and Vitamin D Supplementation Is Not Routinely Indicated for Orthopaedic Surgery Patients.

Testosterone replacement therapy (TRT) is prescribed by endocrinologists and family medicine physicians for decreased levels of androgens in aging males.

• Documented benefits of TRT include improvements in mood, cognition, libido, energy, and quality of life.
• TRT is indicated for hypogonadism in aging males but is not recommended for routine perioperative use in orthopaedic surgery patients.
• TRT carries risks that must be weighed against potential benefits.

TRT may offer potential orthopaedic-relevant benefits in surgical patients of both sexes.

• Potential benefits in orthopaedic surgery patients include improvements in functional outcomes, bone mineral density, lean body mass, and early mobilization.
• These benefits apply to patients of both sexes.
• Despite these potential benefits, TRT is not recommended for routine perioperative management.

Vitamin D supplementation may benefit multiple aspects of orthopaedic recovery.

• Potential benefits of vitamin D include improvements in fracture healing, bone metabolism, muscle recovery, and healing of tendons and wounds.
• Patients may request vitamin D supplementation in the perioperative period.
• Routine supplementation is not indicated despite these potential benefits.

BPC 157, a growth hormone-related peptide, has been identified as a supplement patients may request for surgical recovery.

• BPC 157 may optimize endurance training, metabolism, tissue repair, and surgical recovery.
• It is classified among growth hormone supplements that patients may seek out perioperatively.
• Routine supplementation with BPC 157 is not indicated for orthopaedic surgery patients.

TRT and other supplements including vitamin D and growth hormones carry risks and are not routinely indicated for orthopaedic surgery patients.

• TRT, vitamin D, and growth hormones (specifically BPC 157) all carry risks in the perioperative setting.
• The editorial concludes that TRT 'is not recommended for routine use in the perioperative management of orthopaedic surgery patients.'
• Patients may actively request these supplements, creating a clinical challenge for orthopaedic surgeons.