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

Table 2 Summary of the medical complications

Ref.	VTE	AKI	Pneumonia and sepsis	Cardiac event	Transfusion
ERT
Zhao et al[33]	DVT: OR = 0.52, 95%CI: 0.29-0.91, P = 0.028; PE: OR = 0.67, 95%CI: 0.34-1.32, P = 0.31	NR	NR	NR	NR
Collins et al[32]	THA: DVT (OR = 0.70,95%CI: 0.36-1.27), PE (OR = 1.40, 95%CI: 1.00-1.91). TKA: DVT (OR = 0.63, 95%CI: 0.44-0.88), PE (OR = 0.87, 95%CI: 0.72-1.05)	THA: OR = 0.96, 95%CI: 0.77–1.18; TKA: OR = 1.20, 95%CI: 0.99–1.27	NR	THA: OR = 1.15, 95%CI: 0.93-1.41; TKA: OR = 1.21, 95%CI: 1.05-1.38	THA: OR = 0.91, 95%CI: 0.92-1.01; TKA: OR = 0.85, 95%CI: 0.79-0.92
Hurbanek et al[23]	DVT: OR = 0.66, 95%CI: 0.35-1.18, P = 0.17	NR	NR	NR	NR
McCormick et al[17]	DVT: OR = 0.94, 95%CI: 0.70-1.25, P = 0.6601; PE: OR = 0.80, 95%CI: 0.47–1.36, P = 0.4102	OR = 1.02, 95%CI: 0.72-1.44, P = 0.922	NR	NR	NR
Mousavi et al[30]	DVT: RR = 1.909, 95%CI: 1.145-3.184, P = 0.012; PE: RR = 1.667, 95%CI: 0.933-2.979, P = 0.081	RR = 1.423, 95%CI: 0.866-2.34, P = 0.162	Sepsis: RR = 1.769, 95%CI: 0.899-3.481, P = 0.094	RR = 1.200, 95%CI: 0.520-2.77, P = 0.669	RR = 0.955, 95%CI: 0.527-1.729, P = 0.878
TRT
Ni et al[29]	PE: OR = 1.45, 95%CI: 1.04-2.02, P = 0.029; DVT: OR = 1.27, 95%CI: 0.98-1.65, P = 0.073	NR	NR	NR	NR
Omurzakov et al[28]	90 days: PE (OR = 1.4, 95%CI: 1.0-1.8, P = 0.041), DVT (OR = 1.2, 95%CI: 1.0-1.5, P = 0.127); 1 year: PE (OR = 1.3, 95%CI: 1.1–1.7, P = 0.015), DVT (OR = 1.4, 95%CI: 1.1-1.6, P < 0.001)	90 days: OR = 1.5, 95%CI: 1.2-1.8, P < 0.001; 1 year: OR = 1.6 95%CI: 1.4-1.8, P < 0.001	90 days: Pneumonia (OR = 1.8, 95%CI: 1.4-2.3, P < 0.001), sepsis (OR = 1.8, 95%CI: 1.3-2.4, P < 0.001); 1 year: Pneumonia (OR = 1.6, 95%CI: 1.3-1.8, P < 0.001), sepsis (OR = 1.7, 95%CI: 1.4-2.2, P < 0.001)	90 days: OR = 1.3, 95%CI: 1.0-1.8, P = 0.055; 1 year: OR = 1.3, 95%CI: 1.0-1.6, P = 0.018	NR
White et al[27]	90 days: VTE (OR = 1.42, 95%CI: 0.91-2.20, P = 0.121); 1 year: VTE (OR = 1.59, 95%CI: 1.15-2.21, P = 0.005)	90 days: OR = 1.37, 95%CI: 1.03-1.84, P = 0.033; 1 year: OR = 1.54, 95%CI: 1.25-1.91, P < 0.001	NR	90 days: OR = 1.48, 95%CI: 0.82-2.67, P = 0.185; 1 year: OR = 1.15, 95%CI: 0.75-1.76, P = 0.516	90 days: OR = 1.14, 95%CI: 0.69-1.89, P = 0.607; 1 year: OR = 1.38, 95%CI: 0.93-2.05, P = 0.110
Jing et al[31]	0.0% vs 0.7%, P = 1.00			0.0% vs 0.3% P = 1.00
Collins et al[32]	TKA: DVT (OR = 0.74, 95%CI: 0.51-1.06), PE (OR = 0.95, 95%CI: 0.75-1.19); THA: DVT (OR = 1.24, 95%CI: 0.77-1.98), PE (OR = 1.02, 95%CI: 0.68-1.50)	TKA: OR = 1.24, 95%CI: 1.10–1.40; THA: OR = 1.22, 95%CI: 1.01-1.47	NR	TKA: OR = 1.03, 95%CI: 0.91-1.16; THA: OR = 0.96, 95%CI: 0.80-1.15	TKA: OR = 0.74, 95%CI: 0.64–0.86; THA: OR = 0.90, 95%CI: 0.74-1.07

AKI: Acute kidney injury; CI: Confidence interval; DVT: Deep venous thrombosis; ERT: Estrogen replacement therapy; NR: Not reported; OR: Odds ratio; PE: Pulmonary embolism; RR: Risk ratio; THA: Total hip arthroplasty; TKA: Total knee arthroplasty; TRT: Testosterone replacement therapy; VTE: Venous thromboembolism.