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The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Effect of Supplemental Testosterone Use on Shoulder Arthroplasty Infection Rates.

Favian Su1, Charles J Cogan1, Juan Serna1

  • 1Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA.

Seminars in Arthroplasty
|January 16, 2026
PubMed
Summary
This summary is machine-generated.

Supplemental testosterone use within six months of shoulder arthroplasty is linked to increased prosthetic joint infection risk. Stopping testosterone before surgery may mitigate this risk, warranting physician screening and discussion.

Keywords:
Cutibacterium acnesoutcomesprosthetic joint infectionrevisionshoulder arthroplastytestosterone

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Area of Science:

  • Orthopedic Surgery
  • Infectious Disease
  • Endocrinology

Background:

  • Supplemental testosterone use can increase skin Cutibacterium acnes load.
  • Higher C. acnes loads correlate with increased bacteria in deep tissues.
  • The risk of prosthetic joint infection from preoperative testosterone use is unknown.

Purpose of the Study:

  • To determine if preoperative testosterone use is associated with an increased risk of prosthetic joint infection after shoulder arthroplasty.
  • To investigate the temporal relationship between testosterone use and infection risk.

Main Methods:

  • A retrospective cohort study using the PearlDiver database.
  • Identified patients undergoing shoulder arthroplasty with at least 2-year follow-up.
  • Compared infection rates between patients with and without testosterone use, stratifying by duration since last use.

Main Results:

  • Testosterone use within 6 months of surgery was associated with a higher prosthetic joint infection rate (3.4% vs. 2.4%).
  • No significant infection risk increase was observed for testosterone use between 6-12 months prior.
  • Younger age and diabetes were independent risk factors for infection.

Conclusions:

  • Testosterone use within 6 months before shoulder arthroplasty may increase prosthetic joint infection risk.
  • Cessation of testosterone before surgery may reduce infection rates.
  • Surgeons should screen patients for testosterone use and consider discussing cessation.