The perioperative use of GLP-1 receptor agonists in patients undergoing hip and knee arthroplasty: a scoping review

Glucagon-like peptide-1 receptor agonists (GLP-1As) are increasingly being used for managing obesity and type 2 diabetes mellitus (T2DM). As obesity is a risk factor for both osteoarthritis (OA) and total joint arthroplasty (TJA), GLP-1As are commonly prescribed to surgical candidates. However, the trends, outcomes, and complications associated with perioperative GLP-1A use in patients undergoing TJA are not yet fully understood. The aim of this review is to summarize the current evidence surrounding their perioperative use.

Four databases (EMBASE, MEDLINE, Scopus, and CINAHL) were searched to identify studies that investigated perioperative GLP-1As use in patients undergoing TJA. Relevant data was extracted and findings were described qualitatively in a concept map and table.

A total of eleven studies were included in this review. Eight studies investigated the impact of perioperative GLP-1A use on outcomes following TJA, while three investigated the long-term conversion rate to TJA and development of OA associated with GLP-1A use. Two studies reported the impact on hemoglobin A1c (HbA1c) and/or body mass index (BMI), and ten studies reported complication rates associated with GLP-1A use. Mixed treatment effects and complication rates were found across all above outcome measures. Three studies reported the perioperative GLP-1A withholding period, all of which reported to withhold GLP-1A use 7 days prior to surgery.

This review provides a comprehensive overview of the literature investigating perioperative GLP-1A use in patients undergoing TJA. Based on available data, perioperative GLP-1A use may be associated with improved surgical outcomes following arthroplasty. However, there is uncertainty regarding postoperative complications associated with their use. Given the paucity of evidence, high-quality prospective studies with standardized protocols are needed to better assess their clinical impact.