Associations of estrogen vs testosterone replacement therapy with complications after total joint arthroplasty: A systematic review

Table 1 Characteristics of included studies, mean ± SD

Ref.	Country	Study design	Total	Sample sizes (case/control)	Sex (men/women)		Age (years)		BMI (kg/m2)	Surgery	Study period (years)	Follow-up	Timing of use	Hormone type
					HRT	Non-HRT	HRT	Non-HRT
Ayala-Ortiz et al[21]	United States	Retrospective cohort study	34911	1711/33200	1359/352	12732/20468	NR	NR	NR	TKA	From 2015 to 2022	3 years	At least 3 months preoperatively	TRT
Prieto-Alhambra et al[22]	United Kingdom	Retrospective cohort study	10800	2700/8100 (only women)	2700	8100	64.5 ± 7.7	64.8 ± 8.4	28.4/28.5	THA and TKA	From 1986 to 2006	3.3 years	At least 6 and 12 months preoperatively/postoperatively	ERT
Hurbanek et al[23]	United States	Case-control study	318	108/210 (only women)	108	210	67	74	29/29	THA and TKA	From 1997 to 2002	NR	discontinued on the day of surgery or within 2 weeks preoperatively	ERT
Su et al[24]	United States	Retrospective cohort study	43997	2285/41712 (only men)	2285	41712	61.7 ± 9.4	66.2 ± 9.6	NR	TSA	From 2010 to 2020	2 years	Within 6 and 12 months preoperatively	TRT
Parmar et al[25]	United States	Retrospective cohort study	3812	1906/1906	1706/200	1706/200	68.66	68.73	NR	TSA	From 2010 to 2022	2 years	Within 90 days postoperatively	TRT
Corban et al[26]	United States	Retrospective cohort study	1443	481/962	481	962	60.6	60.5	NR	TSA	From 2017 to 2021	Up to a maximum of 3 years or until December 31, 2022	Within 12 months preoperatively	TRT
White et al[27]	United States	Retrospective cohort study	2738	1369/1369	668/701	652/717	68.3 ± 10.3	68.2 ± 10.4	31.2 ± 7.1/31.15 ± 6.7	TSA	Surgery before 2020	5 years	within 1 year preoperatively	TRT
Omurzakov et al[28]	United States	Retrospective cohort study	291517	6911/284606	2877/4034	102203/182403	67 ± 9.8	66 ± 10.7	NR	TKA	Surgery before 2020	5 years	within 1 year preoperatively	TRT
Ni et al[29], THA	United States	Retrospective cohort study	2888	1444/1444	1330/114	1330/114	61	61	NR	THA	From 2005 to 2025	3 months	within 3 months postoperatively	TRT
Ni et al[29], TKA	United States	Retrospective cohort study	3990	1995/1995	1853/142	1853/142	64	64	NR	TKA	From 2005 to 2025	3 months	within 3 months postoperatively	TRT
Mousavi et al[30]	United States	Retrospective cohort study	3558	1779/1779 (only women)	1779	1779	70.2 ± 8.3	70.4 ± 8.3	NR	TSA	From 2004 to 2024	NR	At least 1-5 years preoperatively	ERT
Jing et al[31]	United States	Retrospective cohort study	440	146/294 (only men)	146	294	NR	NR	NR	THA	NR	90 days	Within 3 months preoperatively	TRT
Coden et al[18]	United States	Retrospective cohort study	35299	3209/32090 (only men)	3209	32090	NR	NR	NR	TKA	NR	1.9 years	Within 1 year preoperatively	TRT
Collins et al[32], THA-TRT	United States	Retrospective cohort study	33423	6725/26698	6725	26698	61.7 ± 8.6	61.9 ± 8.5	NR	THA	From 2010 to 2021	2 years	Within 6 months preoperatively and 6 months postoperatively	TRT
Collins et al[32], TKA-TRT	United States	Retrospective cohort study	71292	14290/57002 (only men)	14290	57002	62.6 ± 8.0	62.6 ± 8.0	NR	TKA	From 2010 to 2021	2 years	Within 6 months preoperatively and 6 months postoperatively	TRT
Collins et al[32], THA-ERT	United States	Retrospective cohort study	31429	6302/25127 (only women)	6302	25127	66.6 ± 7.8	66.6 ± 7.7	NR	THA	From 2010 to 2021	2 years	Within 6 months preoperatively and 6 months postoperatively	ERT
Collins et al[32], TKA-ERT	United States	Retrospective cohort study	82477	16525/65952 (only women)	16525	65952	65.5 ± 8.0	62.6 ± 8.0	NR	TKA	From 2010 to 2021	2 years	Within 6 months preoperatively and 6 months postoperatively	ERT
Zhao et al[33], THA	United States	Retrospective cohort study	10275	3425/6850 (only women)	3425	6850	62	63	NR	THA	From 2015 to 2020	90 days	Within 90 days preoperatively and 90 days postoperatively	ERT
Zhao et al[33], TKA	United States	Retrospective cohort study	22227	7409/14818 (only women)	7409	14818	62	63	NR	TKA	From 2015 to 2020	90 days	Within 90 days preoperatively and 90 days postoperatively	ERT
McCormick et al[17]	United States	Retrospective cohort study	43296	3936/39360 (only women)	3936	39360	NR	NR	NR	THA	NR	NR	Within 12 months preoperatively	ERT

ERT: Estrogen replacement therapy; HRT: Hormone replacement therapy; THA: Total hip arthroplasty; TKA: Total knee arthroplasty; TRT: Testosterone replacement therapy; TSA: Total shoulder arthroplasty; NR: Not reported.