Your healthcare provider can help you stay on top of your bone health. You may never know you have it until you suddenly break a bone. But osteoporosis isn’t always preventable. Talk to your healthcare provider if you’re worried about your risk of falls or bone fractures. Broken bones can always cause complications. Comparison of complications after reverse total shoulder arthroplasty (RSA) in testosterone replacement therapy (TRT) cohort and matched control cohort. Comparison of patient demographics of testosterone replacement therapy (TRT) cohort and matched control cohort. There were a total of 1906 patients who used TRT within 90 days of undergoing RSA and at least 2 years of follow-up after surgery. Patient demographics, comorbidities, and surgical complications were compared between the RSA group and the control group to determine if TRT use within 90 days of surgery has any effect on the surgical outcomes. For the present study, patients who were on TRT within 90 days of undergoing RSA were included (1906 patients). Compared to a matched control cohort, patients who used TRT within 90 days did not have significantly different rates of revision RSA. Furthermore, patients who were using TRT did not have a statistically different Charlson Comorbidity Index score compared to those not using TRT (2.78 ± 2.35 vs. 2.78 ± 2.33). Both groups contained a majority of biological males (89.5%), with an average age of 68 years. It was ensured that these complications occurred after the index surgery in order to prevent confounding factors or diagnoses that may have been made prior to the surgery. The Charlson Comorbidity Index is an index that is widely used throughout medicine that helps predict 10-year survival in patients with many comorbidities . A matched population of those not on TRT but who still underwent RSA was created with propensity score matching using age, Charlson Comorbidity Index, and gender as the variables. A total of 1,804,865 patients who were on TRT in the same time period were identified. Although there was no significant difference in the number of patients with meniscal tears between the groups, the presence of meniscal tears may have had an outsized influence on clinical outcome measures by affecting patients’ weightbearing status after surgery. While patients with unstable, longitudinal meniscal tears were excluded from the present study, 6 patients underwent meniscal repair during surgery. The challenge of recruiting patients for ACL clinical trials has been previously noted in the literature, including a study by Frobell et al16 that indicated more than 5 patients must be screened for every person ultimately included in an ACL study. Nonetheless, the present study did not find significant differences in clinical scores between the testosterone and placebo groups. Furthermore, there was no observed decrease below baseline observed in serum testosterone levels in the testosterone group. 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 . Ethical approval for this study was obtained from the University of Southern California’s Institutional Review Board. These included physical therapy duration and frequency, as well as prior activity level, which may not have been equally distributed between the groups. The main limitation of the present study is the relatively small sample size. Data shown are the means ± standard errors of serum testosterone (ng/dL) as measured by blood analysis. Assuming a dropout rate of 20%, it was estimated that 14 patients would be needed in total.
