Outcomes of Glucagon-Like-Peptide-1 Receptor Agonists (GLP-1A) and Patients Undergoing Total Hip Arthroplasty (THA):
Troy B Puga1, Tanner Haechten2, Vincent Dieu3
1Department of Orthopaedics, Medical City Denton, Denton, Texas, USA.
Background:
Glucagon-Like-Peptide-1 Receptor Agonists (GLP-1a) medications have rapidly grown in popularity, however, their effects on the outcomes of Total Hip Arthroplasty (THA) remain largely unclear. The objective of this systematic review and meta-analysis is to evaluate the outcomes of patients undergoing THA and using a GLP-1a medication.
Methods:
A search was conducted across six databases. The search used a combination of keywords and Medical Subject Heading (MeSH) terms. Titles and abstracts were screened for eligibility for inclusion criteria. Full texts were screened and included if they met eligibility criteria. Demographics and results of the studies were extracted from included articles. Meta-analysis was conducted.
Results:
In this systematic review and metaanalysis, 10 studies met final inclusion criteria, and nine studies met inclusion for meta-analysis. Patients using GLP-1a medications in the setting of THA to those not using GLP-1a medications found a statistically significant decrease in the odds of readmission (OR: 0.81 (95% CI: 0.70-0.93); P<0.001), and no significant difference in the odds of surgical site infections (OR: 0.85 (95% CI: 0.601.20); P=0.36). At 90 days, there was no significant difference in prosthetic joint infections (OR: 1.19 (95% CI: 0.92-1.54); P=0.18), periprosthetic fractures (OR: 1.17 (95% CI: 0.82-1.68); P=0.40), and surgical or medical complications (OR: 0.84 (95% CI: 0.68-1.03); P=0.10) (Figures 4-6). At 2 years, there was no significant difference in periprosthetic fractures (OR: 0.99 (95% CI: 0.531.84); P=0.97) or prosthetic joint infections (OR: 0.98 (95% CI: 0.67-1.44); P=0.93).
Conclusion:
The findings of this study suggest that patients using GLP-1a medications while undergoing THA had reduced 90 day readmission rates, with equivalent rates of SSI, medical and surgical complications, PJI at 90 days and 2 years, and periprosthetic fracture 90 days and 2 years when compared with those not using GLP-1a medications. GLP-1a medications may be safely used in patients undergoing THA.
Level Of Evidence:
III.
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