Testosterone Therapy Tied to Higher Complications in Knee Replacement Patients — American Academy of Orthopaedic Surgeons

Event summary

A study of 13,250 patients found testosterone therapy users had higher postoperative risks for infection, blood clots, and kidney damage after total knee replacement.
Testosterone users faced significantly higher rates of complications at 90 days, one year, and five years post-surgery compared to non-users.
The study is the largest of its kind and includes near-equal numbers of men and women, addressing a gap in previous research.
Prescriptions for testosterone therapy have risen from 7.3 million in 2019 to over 11 million in 2024.

The big picture

With total knee arthroplasty surgeries expected to exceed one million per year by 2030 and the rising popularity of testosterone therapy, this study highlights a critical intersection of orthopedic surgery and hormone therapy. The findings could influence clinical guidelines and patient counseling, particularly as women represent a growing share of knee replacement patients.

What we're watching

Regulatory Scrutiny: How increased evidence of health risks may prompt regulatory bodies to review the safety and marketing of testosterone therapy.
Market Impact: Whether these findings will lead to a decline in testosterone therapy prescriptions, particularly among patients considering joint replacement surgeries.
Future Research: The pace at which additional studies will confirm or refute these findings, and whether they will extend to other types of joint replacements.