The association of GLP-1 receptor agonists and outcomes following midfoot arthrodesis.

BACKGROUND

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly utilized in managing type 2 diabetes mellitus (T2DM) and obesity. Emerging evidence suggests their role in enhancing bone metabolism, with potential implications for orthopedic outcomes.

PURPOSE: To evaluate the impact of perioperative GLP-1RA use on outcomes following midfoot arthrodesis.

STUDY

DESIGN

This retrospective cohort study used the TriNetX U.S. Collaborative Network to evaluate outcomes following midfoot fusion in patients with versus without perioperative GLP-1RA use.

METHODS

Patients were propensity score matched (1:1) for key demographic and clinical variables. Primary outcomes included 90-day and 1-year surgical complications, nonunion, and mechanical issues. Logistic regression models were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS

Among 1504 matched patients (752 per cohort), GLP-1RA use was associated with significantly reduced odds of nonunion at 1 year (OR = 0.712; 95% CI = 0.52-0.958). However, GLP-1RA users had higher 90-day rates of wound complications (OR = 1.713, 95% CI = 1.141-2.57), irrigation and debridement (OR = 1.873; 95% CI = 1.223-2.869), and elevated 1-year mechanical complications rates (OR = 2.446; 95% CI = 1.552-3.857). No significant differences were observed in infection rates or overall hospital admissions.

CONCLUSION

There is an observed association with perioperative GLP-1RA use and lower nonunion rates following midfoot arthrodesis, indicating a potential benefit for bone healing. However, increased mechanical and wound-related complications warrant further investigation into their surgical safety profile in foot and ankle procedures.