Survey of short-term oral corticosteroid administration by orthopaedic physicians in college and high school athletes.

The use of oral corticosteroid (OCS) drugs is advocated because of their potent anti-inflammatory effects. They also possess many potential adverse effects. No study has assessed physician prescribing practices of OCS therapy in high school (HS) or college (COL) athletes. This paper reports the prescribing patterns of sports medicine physicians who used short-term OCS therapy and to describe associated complications in HS and COL athletes within a 24- month period. An internet link to a descriptive epidemiology survey was included in an e-mail to all members of the Arthroscopy Association of North America and the American Orthopaedic Society for Sports Medicine. Descriptive statistics and correlation analysis were used to examine responses. Total response rate was 32% (615/1,928). Sixty-six percent of the physicians indicated prescribing OCS to both groups of athletes, while 29% reported prescribing OCS to COL athletes and 5% to HS athletes for musculoskeletal injuries. Physicians who prescribed multiple OCS regimens to the same athlete within the same season (P = 0.01) and physicians who prescribed OCS to the skeletally immature athlete (P = 0.009) reported more complications than other physicians. Among the 412 physicians who did not prescribe OCS in the treatment of athletic induced musculoskeletal injury, 251 (61%) cited a risk of developing medical complications as the primary reason for avoiding use. The reported number of medical complications was low with no cases of avascular necrosis reported for the 2-year recall period. Orthopaedic surgeons who treated athletic induced musculoskeletal injuries with a short-term course of oral corticosteroids reported that high school and college athletes benefited with few medical complications. Key pointsThirty-four percent of orthopaedic sports medicine physicians we surveyed reported prescribing a short-term course of oral corticosteroids for the treatment of an athletic-related musculoskeletal injury within the previous 24 months of answering the survey.The orthopaedic surgeons who treated athletic induced musculoskeletal injuries with a short-term course of OCS reported the high school and college athletes benefited from OCS treatment with few medical complications.Short-term oral corticosteroid use in multiple regimens in the same athlete and in the skeletally immature athlete may pose an increased risk of medical complication.