Shah · JBJS reviews 2026 · systematic review and meta-analysis · n=22 studies (1,157 patients)

Human Growth Hormone as a Therapeutic Treatment Option in Orthopaedics: A Systematic Review of Dosing, Side Effects, and Clinical Outcomes.

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Level 2 - randomized trial

Systematic review of Level I and Level II clinical trials

PubMed 41557825 · doi:10.2106/JBJS.RVW.25.00194 · record verified 2026-08-27

What was done

A systematic review and meta-analysis searched PubMed, MEDLINE, and Embase to assess dosing, adverse events, and clinical outcomes of recombinant human growth hormone (rHGH) in human orthopaedic clinical studies. Data were extracted from 22 included studies of moderate methodological quality comprising 1,157 patients (mean age 54.3 years; mean rHGH dose 1.49 mg/day) and pooled for analysis.

What was found

Administration of rHGH produced a dose-dependent increase in serum IGF-1 (mean increase +133.2%). Compared to placebo, rHGH was associated with small increases in lean body mass (mean difference +3.63%, increased in 15 of 23 studies) and leg extension strength (mean difference +3.17%). Treatment also significantly increased adverse events: carpal tunnel symptoms (odds ratio [OR] = 3.85), peripheral edema (OR = 3.03), and arthralgias (OR = 2.94).

Why it matters

This review summarizes the clinical efficacy and risk profile of rHGH in orthopaedic contexts, demonstrating that modest gains in muscle strength and lean mass come with substantial increases in fluid retention and musculoskeletal adverse events.

Limits

Included primary studies possessed only moderate methodological quality. Clinical effect sizes were small (around 3% improvement over placebo), long-term safety and fracture-specific outcomes were not detailed in the abstract, and an internal discrepancy exists in the reported study counts (22 included studies vs. 23 studies evaluated for lean body mass).

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