Testosterone Replacement Therapy in Orthopaedic Surgery.
Randy M CohnMaximillian P GanzGiles R ScuderiPublished in: The Journal of the American Academy of Orthopaedic Surgeons (2024)
Testosterone replacement therapy (TRT) is an indicated treatment of several medical conditions including late-onset hypogonadism, congenital syndromes, and gender affirmation hormonal therapy. Increasing population age, medical benefits, and public awareness of TRT have resulted in increased prevalence of its utilization. However, TRT is not without concern for adverse risks including venous thromboembolic complications, cardiovascular events, and prostate issues. In the field of orthopaedic surgery, research is beginning to delineate the complex relationship between TRT and the development of orthopaedic conditions and potential effects on surgical interventions and outcomes. In this review, we discuss current literature surrounding TRT and subsequent development of osteoarthritis, incidence of total joint arthroplasty, musculotendinous pathology, postoperative infection risk, improvements in postoperative rehabilitation metrics, enhancement of osseous healing, and increased bone-implant integration. The authors suggest future areas of investigation that may provide guidance on how surgeons can mitigate adverse risks while optimizing benefits of TRT in the orthopaedic patient.
Keyphrases
- replacement therapy
- late onset
- cardiovascular events
- smoking cessation
- minimally invasive
- healthcare
- risk factors
- coronary artery bypass
- human health
- patients undergoing
- early onset
- prostate cancer
- coronary artery disease
- cardiovascular disease
- mental health
- systematic review
- soft tissue
- physical activity
- rheumatoid arthritis
- risk assessment
- bone mineral density
- adverse drug
- quality improvement
- percutaneous coronary intervention
- metabolic syndrome
- acute coronary syndrome
- atrial fibrillation
- skeletal muscle
- benign prostatic hyperplasia
- bone marrow
- body composition
- drug induced