Arthroplasty today · 2026
Preoperative Weight Loss Before Total Joint Arthroplasty Using Novel Glucagon-Like Peptide-1 Agonists.
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Seward Michael W, Cleary Emmett J, DeNovio Anthony C, Grimm Jessica A, Curry Timothy B, Beam Brian B, Hannon Charles P, Abdel Matthew P
Аннотация
BACKGROUND: This study determined the prevalence of glucagon-like peptide-1 (GLP-1) use before total joint arthroplasty (TJA), measured weight loss of patients on GLP-1s, and evaluated if GLP-1s were associated with outcomes.
METHODS: We identified 6482 patients (2990 hips; 3492 knees) who had primary TJAs between 2019 and February 2023. The mean age was 67 years, 50% were female, and 12% had a body mass index ≥40 kg/m2. Univariable and multivariable models evaluated outcomes. Mean follow-up was 3 years.
RESULTS: The prevalence of GLP-1s before TJA was 3%, increasing from 2% in 2019 to 5% in 2022. The mean preoperative weight change on GLP-1s was -9 pounds (range, -110 to +36 pounds). Among patients taking GLP-1s, 19% lost ≥20 pounds prior to surgery, and the mean body mass index change was -1.4 kg/m2 (range, -16.3 to 6.2 kg/m2). In univariable analyses, GLP-1 use was not associated with revisions (P = .35), reoperations (P = .09), or complications (P = .23). In multivariable analyses, GLP-1s were not associated with revisions (P = .66), reoperations (P = .34), or complications (P = .85). There was no difference in the risk of a 90-day postoperative emergency department visit between those on GLP-1s vs not on those medications (odds ratio, 1.5; P = .07).
CONCLUSIONS: The prevalence of preoperative GLP-1s before TJA increased from 2% in 2019 to 5% in 2022, and preoperative weight change on GLP-1s varied considerably. GLP-1s were not associated with decreased postoperative risks but investigational GLP-1s before TJA require further study.
LEVEL OF EVIDENCE: Level III.
METHODS: We identified 6482 patients (2990 hips; 3492 knees) who had primary TJAs between 2019 and February 2023. The mean age was 67 years, 50% were female, and 12% had a body mass index ≥40 kg/m2. Univariable and multivariable models evaluated outcomes. Mean follow-up was 3 years.
RESULTS: The prevalence of GLP-1s before TJA was 3%, increasing from 2% in 2019 to 5% in 2022. The mean preoperative weight change on GLP-1s was -9 pounds (range, -110 to +36 pounds). Among patients taking GLP-1s, 19% lost ≥20 pounds prior to surgery, and the mean body mass index change was -1.4 kg/m2 (range, -16.3 to 6.2 kg/m2). In univariable analyses, GLP-1 use was not associated with revisions (P = .35), reoperations (P = .09), or complications (P = .23). In multivariable analyses, GLP-1s were not associated with revisions (P = .66), reoperations (P = .34), or complications (P = .85). There was no difference in the risk of a 90-day postoperative emergency department visit between those on GLP-1s vs not on those medications (odds ratio, 1.5; P = .07).
CONCLUSIONS: The prevalence of preoperative GLP-1s before TJA increased from 2% in 2019 to 5% in 2022, and preoperative weight change on GLP-1s varied considerably. GLP-1s were not associated with decreased postoperative risks but investigational GLP-1s before TJA require further study.
LEVEL OF EVIDENCE: Level III.