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

Patients on TRT had a significantly greater proportion of 90-day periprosthetic joint infection (PJI) compared to controls.

• PJI rate was 3.4% (n=5) in the TRT cohort versus 0.3% (n=1) in the No TRT cohort (P = .017).
• 146 TRT patients were compared to 294 control patients not on TRT.
• TRT was defined as use within 3 months prior to surgery.
• Cohorts were propensity score matched using nearest-neighbor method with age, ASA score, and BMI as covariates.

There was no significant difference in 90-day postoperative ED encounters, readmission rates, DVT, MI, or PE between TRT and No TRT cohorts.

• All comparisons for these outcomes yielded P > .05.
• These complications were described as 'similar and low between cohorts.'
• The study population included 146 TRT patients and 294 control patients from a large academic medical center.
• Outcomes were assessed at 90 days postoperatively.

Twenty-four-month revision rates were similar between the TRT and No TRT cohorts.

• No statistically significant difference in 24-month revision rates was observed (P > .05).
• Revision rates were collected as a secondary outcome in addition to 90-day complications.
• The study was a retrospective cohort analysis from a large academic medical center.

TRT use has increased in popularity over the past decade and has been associated with medical risks including venous thromboembolism.

• The study was motivated by the rising prevalence of TRT and its known association with venous thromboembolism.
• The study aimed to characterize perioperative and postoperative complications in THA patients taking TRT in the perioperative period.
• TRT exposure was defined as use within 3 months prior to surgery.

The authors conclude that further studies are needed to identify the optimal discontinuation of TRT prior to joint replacement.

• The finding of increased PJI in TRT users was the basis for this recommendation.
• No specific discontinuation protocol was established by this study.
• The retrospective, single-center design was a limitation noted implicitly by the call for further studies.