Glucagon-Like Peptide-1 Receptor Agonists Decrease Medical and Surgical Complications in Morbidly Obese Patients...

Area of Science:

• Orthopedic Surgery
• Endocrinology
• Pharmacology

Background:

• Weight optimization in morbidly obese patients (BMI ≥40 kg/m²) undergoing total knee arthroplasty (TKA) yields varied results.
• The study investigates the impact of perioperative glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on TKA outcomes in this patient group.

Purpose of the Study:

• To evaluate the effect of perioperative GLP-1 RA use on complication rates in morbidly obese patients (BMI ≥40 kg/m²) undergoing primary TKA.
• To compare outcomes between GLP-1 RA users and non-users, as well as with a cohort of less obese patients (BMI 35.0-39.9 kg/m²).

Main Methods:

• Retrospective analysis of an administrative claims database.
• Patients with morbid obesity undergoing TKA were stratified into GLP-1 RA users (≥3 months pre- and post-surgery) and non-users.
• Matching criteria included age, gender, type-2 diabetes, and Charlson Comorbidity Index; comparison with a BMI 35.0-39.9 kg/m² cohort.

Main Results:

• GLP-1 RA users showed significantly lower rates of 90-day periprosthetic joint infection (PJI), overall medical complications, pulmonary embolism, and readmissions.
• No significant differences in 2-year surgical complication rates were observed between GLP-1 RA users and non-users.
• Patients with BMI ≥40 kg/m² on GLP-1 RAs had complication rates comparable to obese patients (BMI 35.0-39.9 kg/m²).

Conclusions:

• Perioperative GLP-1 RA use for at least 90 days before and after TKA in morbidly obese patients (BMI ≥40 kg/m²) is associated with reduced 90-day PJI, medical complications, and readmission.
• The achieved complication reduction is similar to that of obese patients (BMI 35.0-39.9 kg/m²) undergoing TKA.
• Further randomized clinical trials are warranted to confirm the definitive impact of GLP-1 RAs on TKA outcomes.