J Arthroplasty

AAOS 2026: Testosterone therapy tied to higher complication risks after knee replacement

March 9, 2026

A large-scale study presented at the 2026 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) reported that total knee arthroplasty (TKA) patients using testosterone therapy (TRT) in the year before surgery faced markedly higher complication rates. Compared with nonusers, TRT users had significantly greater risks of postoperative infection, thromboembolic events, acute kidney injury, pneumonia, and knee instability. These heightened risks continued for as long as five years after surgery.

Clinical takeaway: Screen for TRT before TKA and counsel patients on elevated medical and periprosthetic risks; consider closer postoperative monitoring for those using TRT.

Sources:

Omurzakov A, et al. (2025, October 31). J Arthroplasty. Preoperative Testosterone Replacement Therapy Is Associated With Increased Complication Risk After Total Knee Arthroplasty: A Propensity-Matched Analysis of 13,250 Patients. https://pubmed.ncbi.nlm.nih.gov/41177190/

(2026, March 2). American Academy of Orthopaedic Surgeons. New research links testosterone therapy with serious health risks after total knee replacement surgery [News release]. https://aaos-annualmeeting-presskit.org/2026/research-news/new-research-links-testosterone-therapy-with-serious-health-risks-after-total-knee-replacement-surgery/