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A total of 98,782 patients who underwent RSA with at least 2 years of follow-up were identified. Patients over the age of 18 of either biological sex were included from the years 2010 to 2022. To ensure there was proper follow-up of patients, patients who were on TRT must have had active medical records 1 year before and 2 years after the prescription was filled. Of note, CPT codes were unable to be used to identify patients who underwent RSA because the current CPT codes used in shoulder arthroplasty include all forms of shoulder arthroplasty. It was also queried for all individuals who were taking a form of TRT, which was defined by getting a prescription of any form of testosterone.
Participants in the testosterone group received 200 mg of intramuscular testosterone weekly for 8 weeks beginning 2 weeks before surgery. Testosterone supplementation may likewise counteract this muscle loss and potentially improve clinical outcomes. With the rise in RSA surgeries over recent decades and the increased use of testosterone for hypogonadism or gender-affirming therapy, there will be individuals on testosterone who will need this surgery. Further, another limitation is the inability to perform subgroup analyses based on baseline testosterone levels, preoperative pathologies, or comorbidity indices, as the database does not provide the necessary detailed patient-level data for such distinctions. Furthermore, this study did not look at the amount of testosterone that was taken, nor the exact time before surgery the testosterone was taken. Furthermore, patients who used TRT within 90 days of surgery had PJI rates that were similar to the control group following RSA in the present study. A recent study queried a large prospective study and found that for patients undergoing total hip arthroplasty or total knee arthroplasty, rates of revision within two years of surgery were statistically higher in the TRT group compared to the control group .
You might have brittle bones, but an osteoporosis diagnosis doesn’t mean you can’t keep having fun in life. And they’ll suggest ways to strengthen your bones. They’ll help you monitor your bone density. Your provider will monitor any changes in your bone density and will adjust your treatments as needed.
Testosterone use has increased in recent years, particularly due to its beneficial impacts on sexual function , mood , muscle mass 30,31, and cognitive function in patients with hypogonadism. The primary outcome of this study was to determine the rates of revision RSA following surgery in patients who used TRT within 90 days of initial surgery. Another study found a higher risk of rotator cuff pathology in patients who were prescribed testosterone .
Together, we will create a comprehensive treatment plan to meet your needs and help you build strength, improve bone health, and get you back to the things you love. Likewise, the distribution of graft types was not significantly different between the groups, but previous studies have shown that graft type may influence outcomes of ACL repair.5,33,52 Furthermore, postoperative imaging of the graft was not performed. It is also necessary to consider that a higher dose of testosterone supplementation may achieve greater physiological effects while maintaining safety. The lack of adverse events suggests that testosterone administration at 200 mg/wk may be safe in young, healthy men undergoing surgery. As testosterone is a potent hormone acting on various organ systems, side effects and safety of the intervention were paramount concerns.
Rehabilitation after repair of the anterior cruciate ligament (ACL) is complicated by the loss of leg muscle mass and strength. Furthermore, another study demonstrated that screws coated with testosterone had a greater contact surface between the bone and the implant, indicating there may be an underlying physiologic impact on bone strength . While several studies have reported on TSA complications with TRT, including prosthetic joint infection, this is the first large retrospective study to specifically assess the complications following RSA in patients taking testosterone. Hypogonadism in males is a clinical syndrome resulting in decreased muscle mass, bone mass, libido, and sexual desire, and TRT is the standard prescription for these symptoms . Three studies evaluated the effects of testosterone on patients undergoing hip fracture fixation.
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