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Does Semaglutide Use Decrease Complications and Costs Following Total Knee Arthroplasty?

Matthew L Magruder1, Vincent J H Yao2, Ariel N Rodriguez1

  • 1Department of Orthopaedic Surgery, Maimonidies Medical Center, Brooklyn, New York.

The Journal of Arthroplasty
|June 6, 2023
PubMed
Summary
This summary is machine-generated.

Semaglutide use in total knee arthroplasty (TKA) patients with diabetes showed reduced sepsis, infection, and readmission risks. However, it also increased risks for myocardial infarction, kidney injury, pneumonia, and hypoglycemia.

Keywords:
complicationsdiabetes mellitusprosthetic joint infectionssemaglutidesepsistotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Endocrinology
  • Pharmacology

Background:

  • Diabetes mellitus (DM) and obesity are known risk factors for complications following total knee arthroplasty (TKA).
  • Semaglutide, a medication used for DM and weight management, may influence TKA outcomes.

Purpose of the Study:

  • To investigate the impact of semaglutide use on medical and implant-related complications after TKA.
  • To evaluate the effect of semaglutide on readmission rates and costs in TKA patients.

Main Methods:

  • A retrospective analysis of a national database (up to 2021) was conducted.
  • Patients with osteoarthritis undergoing TKA, with DM and semaglutide use, were propensity score-matched to a control group (n=7,051 vs. 34,524).
  • Outcomes assessed included 90-day medical complications, 2-year implant complications, 90-day readmissions, length of stay, and costs, analyzed using multivariate logistic regression.

Main Results:

  • Semaglutide use was associated with increased odds of myocardial infarction, acute kidney injury, pneumonia, and hypoglycemia.
  • Conversely, semaglutide cohorts demonstrated lower odds of sepsis, prosthetic joint infections, and 90-day readmissions.
  • A trend towards lower revision rates and reduced 90-day costs was observed in the semaglutide group.

Conclusions:

  • Semaglutide use in TKA patients with DM is linked to a decreased risk of sepsis, prosthetic joint infections, and readmissions.
  • However, semaglutide use also elevates the risk of specific medical complications, including myocardial infarction, acute kidney injury, pneumonia, and hypoglycemia.