Hormone replacement therapy and complications after primary total shoulder arthroplasty

Background Hormone replacement therapy (HRT) is commonly prescribed to alleviate symptoms of menopause. Incidence of women undergoing total shoulder arthroplasty (TSA) continues to rise, yet the impact of HRT on primary TSA outcomes remains unclear. The purpose of this study is to examine the effects of HRT on postoperative complications following primary TSA. Methods The PearlDiver Mariner database was queried for menopausal aged females undergoing primary TSA between 2010 and 2023. Patients with prior history of breast cancer, deep vein thrombosis (DVT), pulmonary embolism, or stroke were excluded. Patients prescribed HRT within 365 days preoperatively were propensity score matched 1:1 to non-users. Chi-square analysis and multivariable logistic regression were used to evaluate associations between HRT use and postoperative complications. Statistical significance was defined as p < . 05. Results HRT users had lower incidence of acute kidney injury (AKI) ( p = . 02) at 180 days and lower incidence of AKI ( p = . 03) and pneumonia ( p = . 04) at 365 days. HRT was found to be independently predictive of decreased rates of AKI ( p = . 03), UTI ( p = . 02), pneumonia ( p = . 01), and transfusion ( p = . 01) following TSA. Conclusion HRT was found to be independently associated with reduced medical complications following primary TSA and was not associated with surgical complications following primary TSA. Level of evidence Level III – Retrospective cohort study