{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:31:45Z","timestamp":1777876305580,"version":"3.51.4"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Shoulder &amp; Elbow"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Preoperative testosterone exposure has been associated with various health outcomes, but its impact on postoperative complications in patients undergoing total shoulder arthroplasty (TSA) has not been fully explored. This study aims to evaluate the association between preoperative testosterone exposure and postoperative medical and surgical complications in patients undergoing TSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study was conducted using the PearlDiver database. Patients who underwent TSA and used preoperative testosterone within 3 months of the index procedure were identified and matched 1:4 to controls without testosterone use using propensity score matching. Matching was performed based on age, gender, comorbidities, Charlson comorbidity index, obesity, tobacco use, and hypogonadism to balance the groups. Postoperative complications were assessed at 90 days and five years. Statistical comparisons were made using odds ratios (ORs) with 95% confidence intervals (CIs), and a\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value of &lt;0.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The matched cohort included 677 testosterone users and 2554 controls. There were no statistically significant differences between the testosterone and control groups in 90-day complications such as myocardial infarction (OR 2.52,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.31), pneumonia (OR 0.86,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.70), and deep vein thrombosis (no cases in the testosterone group). Over five years, the testosterone group had a significantly higher risk of periprosthetic joint infection (4.1% vs. 2.4%, OR 1.76, 95% CI 1.10\u20132.75,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.015), but no differences in revision rates, dislocation, aseptic loosening, or stiffness were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative testosterone exposure was associated with a higher risk of periprosthetic joint infection following TSA, but no significant differences were found in major medical complications or revision rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17585732261437972","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T10:55:02Z","timestamp":1775559302000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative testosterone therapy linked to higher 5-year risk of periprosthetic joint infection without increased 90-day major complications or revision rates in total shoulder arthroplasty"],"prefix":"10.1177","author":[{"given":"Jad J","family":"Lawand","sequence":"first","affiliation":[{"name":"University of Texas Medical Branch"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3335-2382","authenticated-orcid":false,"given":"Connor","family":"Crutchfield","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sidney Kimmel Medical College at Thomas Jefferson University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro M","family":"Holle","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mayo Clinic Alix School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2776-5076","authenticated-orcid":false,"given":"Olawale A","family":"Sogbein","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7815-9105","authenticated-orcid":false,"given":"Sameer R","family":"Khawaja","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2207-074X","authenticated-orcid":false,"given":"Umar","family":"Ghilzai","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian W","family":"Hill","sequence":"additional","affiliation":[{"name":"Palm Beach Orthopaedic Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7251-6503","authenticated-orcid":false,"given":"Adam Z","family":"Khan","sequence":"additional","affiliation":[{"name":"Southern California Permanente Medical Group"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4802-9913","authenticated-orcid":false,"given":"John G","family":"Horneff","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3845-7220","authenticated-orcid":false,"given":"Joseph A","family":"Abboud","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jseint.2020.04.024"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jseint.2021.09.016"},{"key":"e_1_3_2_4_2","first-page":"166","article-title":"Nationwide trends in total shoulder arthroplasty and hemiarthroplasty for osteoarthritis","volume":"43","author":"Trofa D","year":"2014","unstructured":"Trofa D, Rajaee SS, Smith EL. 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