Association Between GLP-1RAs and Postoperative Complications Following Operative Ankle Fracture Fixation: A...

Area of Science:

• Orthopedic Surgery
• Pharmacology
• Patient Outcomes

Background:

• Ankle fractures are common, particularly in younger adults.
• Operative fixation is a standard treatment for many ankle fractures.
• Understanding perioperative medication effects is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To investigate the association between perioperative glucagon-like peptide-1 receptor agonist (GLP-1RA) use and postoperative complications after operative ankle fixation.
• To evaluate the impact of GLP-1RA therapy on specific complications such as hardware failure, nonunion/malunion, infection, and wound complications.

Main Methods:

• Retrospective cohort study utilizing the TriNetX research network.
• Adult patients undergoing operative ankle fixation were stratified by perioperative GLP-1RA exposure.
• Propensity score matching was employed to balance cohorts on key demographic and clinical factors, though BMI and HbA1c matching was incomplete.

Main Results:

• GLP-1RA therapy was significantly associated with an increased risk of hardware failure at 3, 6, and 12 months postoperatively.
• Higher rates of nonunion/malunion were observed in the GLP-1RA cohort at 6 and 12 months.
• No significant association was found between GLP-1RA use and postoperative infection, wound dehiscence, or procedural complications.

Conclusions:

• Perioperative GLP-1RA use may increase the risk of hardware failure and nonunion/malunion in patients undergoing operative ankle fixation.
• These findings highlight a potential risk to osseous integrity and hardware durability.
• Further research is needed to confirm these hypothesis-generating findings, considering potential residual confounding from BMI and HbA1c.