Glucagon-Like Peptide-1 Receptor Agonists in Orthopedics: A Scoping Review of Emerging Applications

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are currently being utilized extensively to treat obesity and type 2 diabetes. Recent data suggest their broad applications in the field of orthopedics, due to their beneficial effects on bone metabolism, cartilage preservation, and surgical outcomes. The current scoping review attempts to thoroughly assess the role of GLP-1 RAs in orthopedic care by synthesizing the most recent data on their effects on bone health, cartilage preservation, arthroplasty outcomes, and spine surgery.

A comprehensive scoping review was conducted in accordance with PRISMA-ScR guidelines. A systematic search of meta-analyses and systematic reviews of GLP-1 RAs in orthopedic-relevant outcomes, including orthopedic applications, was performed on three different databases (PubMed, Embase, and Scopus) on September 9, 2025, using specific keywords. Data on study design, population, intervention, comparator, and outcomes were extracted and narratively synthesized to draw conclusions.

Eight reviews assessed bone and fracture outcomes, showing that liraglutide reduced fracture risk and improved bone formation markers, while exenatide had mixed effects. Long-term GLP-1 RA use (> 52 weeks) improved lumbar spine and femoral neck bone mineral density (BMD) and reduced fracture incidence. Three reviews evaluated cartilage and joint outcomes, reporting slower cartilage loss, fewer knee surgeries, and symptomatic improvements, with semaglutide showing consistent pain relief and functional gains. In arthroplasty, GLP-1 RA use was associated with reduced periprosthetic joint infection and lower readmission rates, particularly in diabetic and obese patients. In spine surgery, evidence suggested potential reductions in pseudarthrosis but mixed findings for complications and readmissions.

GLP-1 RAs demonstrate promise in bone health, cartilage preservation, and perioperative orthopedic outcomes. However, evidence remains limited by heterogeneity, short follow-up, and underrepresentation of non-diabetic populations.