Testosterone Replacement Therapy in Total Hip Arthroplasty Patients: A Propensity-matched Cohort Analysis of 90-day Outcomes.

BACKGROUND: Testosterone replacement therapy (TRT) has increased in popularity over the past decade. However, TRT has been associated with medical risks, such as venous thromboembolism. The aim of this study was to characterize perioperative and postoperative complications in total hip arthroplasty (THA) patients taking TRT in the perioperative period. MATERIALS AND METHODS: A retrospective review of patients from a large academic medical center was performed to identify primary THA patients who underwent TRT within 3 months prior to surgery. Cohorts were propensity score matched with controls using nearest-neighbor method with age, American Society of Anesthesiologists score, and body mass index as covariates. Outcomes studied included 90-day readmissions, emergency department (ED) encounters, infections, myocardial infarctions (MI), deep venous thrombosis (DVT), and pulmonary embolism (PE). Twenty-four-month revision rates were also collected. RESULTS: One hundred forty-six patients on TRT were evaluated with 294 consecutive control patients not on TRT. There was a significantly greater proportion of 90-day periprosthetic joint infection in the TRT cohort compared to the No TRT cohort (3.4%, n = 5, vs 0.3%, n = 1; P = .017). There was no significant difference in all other postoperative complications between TRT and No TRT cohorts. Ninety-day postoperative ED encounters, readmission rates, DVT, MI, and PE were similar and low between cohorts (P > .05). Twenty-four-month revision rates were also similar between study groups (P > .05). CONCLUSION: This study found that TRT was associated with greater periprosthetic joint infection in THA. Further studies will need to be performed to identify optimal discontinuation of treatment prior to joint replacement.

Duke Scholars

Author Michael Paul Bolognesi Orthopaedic Surgery

Author Sean Ryan Orthopaedic Surgery