Purpose: Reoperation due to infection remains a devastating complication of total hip arthroplasty (THA). Prescriptions for supplemental testosterone are also increasing yearly, which is relevant given the populations who undergo THA and those prescribed testosterone have significant overlap. This study aimed to evaluate supplemental testosterone as a risk factor for all cause reoperation and reoperation due to infection. Materials and Methods: Utilizing the MarketScan Commercial Claims Database (Merative), we performed a retrospective matched cohort study. Out of 61,133 THA procedures in men, Mahalanobis nearest neighbor matching was utilized to achieve a final population for analysis consisting of 1,956 patients prescribed testosterone and the 19,560 patients not prescribed testosterone. Data analyses included univariate and multivariate regression. There were no significant demographic differences between the groups. Results: Prescription testosterone within 1 year of THA was a significant predictor of all cause reoperation (OR=1.6, CI=1.2-2.2, P=0.001) and reoperation due to infection (OR=1.8, CI=1.1-2.7, P=0.01). Men prescribed testosterone were at higher cumulative incidence for both all cause reoperation and reoperation due to infection at years 1 to 5 (P<0.05 for all years).There were more prescriptions for testosterone in the south (P<0.001). Younger age (OR=1.0, CI=0.9-1.0, P=0.01) and diabetes mellitus diagnoses were risk factors for reoperation due to infection (OR=1.6, CI=1.0-2.4, P=0.03). Conclusion Men prescribed testosterone within 1 year prior to THA were more likely to undergo all-cause reoperation and reoperation due to infection. Arthroplasty surgeons should that younger patients have a higher rate of reoperation due to infection as well.

Displaced olecranon fractures constitute a challenging problem for elbow surgeons. The purpose of this study is to evaluate the role of suture anchor fixation for treating patients with displaced olecranon fractures. Methods: A retrospective review was performed for all consecutive patients with displaced olecranon fractures treated with suture anchor fixation with at least 2 years of clinical follow-up. Surgical repair was performed acutely in all cases with nonmetallic suture anchors in a double-row configuration utilizing suture augmentation via the triceps tendon. Osseous union and perioperative complications were uniformly assessed. Results: Suture anchor fixation was performed on 17 patients with displaced olecranon fractures. Functional outcome scores were collected from 12 patients (70.6%). The mean age at the time of surgery was 65.6 years, and the mean follow-up was 5.6 years. Sixteen of 17 patients (94%) achieved osseous union in an acceptable position. No hardware-related complications or fixation failure occurred. Mean postoperative shortened disabilities of the arm, shoulder, and hand (QuickDASH) score was 3.8±6.9, and mean Oxford Elbow Score was 47.5±1.0, with nine patients (75%) achieving a perfect score. Conclusions: Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes. Additionally, this technique resulted in high rates of osseous union without any hardware-related complications or fixation failures. Level of evidence: IV.