Geographical incidence of testosterone supplementation in total hip and knee arthroplasty

• Published in: Journal of orthopaedics 2025-03, Vol.61, p.47-53
• Main Authors: Coden, Gloria, Grant, Andrew, Kuznetsov, Mikhail, Smith, Eric L.
• Format: Article
• Language: English
• Subjects: Geographical trends; Hormone therapy; Supplemental testosterone; Total hip arthroplasty; Total knee arthroplasty
• ISSN: 0972-978X; 0972-978X
• DOI: 10.1016/j.jor.2024.09.002

Prescription testosterone usage in the United States declined after 2013 following reports of its association with myocardial infarction and stroke. However, more recently there has been a documented increase in testosterone prescriptions. Recently, testosterone levels have also been hypothesized to increase infection risk in patients undergoing elective shoulder arthroplasty. Furthermore, testosterone may increase the risk of venous thromboembolism. These complications are perioperative concerns for total hip and knee arthroplasties (THA/TKA). Therefore, the purpose of our study is to identify trends in the incidence of testosterone prescriptions in patients who underwent THA/TKA with respect to geographical population data. We retrospectively reviewed 40,711 primary THAs and 50,893 primary TKAs performed in males between 1/1/2016 and 12/31/2021 using a commercial claims database. Records were reviewed for demographics, geographical location, and supplemental testosterone prescriptions within 1 year prior to surgery. Patient Metropolitan Statistical Area (MSA) was assessed with respect to United States Census Population Data. We identified 91,604 males who underwent primary THA (n = 40,711) or TKA (n = 50,893). For THA/TKA, patients who were younger had a higher likelihood of having a supplemental testosterone prescription (OR = 0.99, 95 % CI [0.99–1.00], p