Two studies examining the use of glucagon-like peptide-1 receptor agonists, including semaglutide, have found short- and long-term associations in orthopedic postoperative outcomes and general healthcare risks.
10 things to know:
1. A study of spine and orthopedic patients with obesity-related diagnosis codes found a consistent increase in GLP-1 and semaglutide use from 2010 to 2023. A marked rise began in 2019.
2. The study included total hip and knee replacement, ACL repair, hip cephalomedullary nail, hip hemiarthroplasty, lumbar fusion, total shoulder arthroplasty, carpal tunnel release, distal radius open reduction internal fixation and ankle ORIF.
3. Across the procedures, the use of GLP-1s was associated with significantly lower odds of postoperative emergency department visits. GLP-1 use was also associated with lower site infection rates in knee and hip replacement patients.
4. Revision rates were lower among GLP-1 users having knee replacements, but they increased in carpal tunnel release patients.
5. “Within orthopaedics, there has been relatively little research on how GLP-1 use affects postoperative outcomes,” Haroun Haque, a medical student and primary investigator of the study, said in a March 2 news release. “Given how dramatically the use of these medications has increased, especially since 2019,i t is important to understand how these may influence surgical recovery and complications.”
6. Another study found that GLP-1 use in general was linked to an increased risk of osteoporosis, gout and osteomalacia in adults with Type 2 diabetes and obesity. The retrospective cohort study evaluated the five-year risk of the conditions in orthopedic patients.
7. A team used a large, multi-institutional electronic medical record–derived database to compare GLP-1 patients with matched controls.
8. The cohort size was 73,483 patients with balanced baseline characteristics. After five years they saw a significantly increased risk of osteoporosis compared to controls and a higher incidence of gout.
9. The greatest relative risk increase was seen for osteomalacia in patients using GLP-1s.
10. “We are just now reaching the precipice where five- and 10-year follow-up data are becoming available for patients taking GLP-1 medications,” Muaaz Wajahahth, a medical student and primary investigator on the study, said in the release. “Any medication that sees this rapid adoption warrants close examination, particularly in orthopedics where obesity and surgical intervention often overlap, and when the long-term effects of GLP-1 RA exposure on bone and joint health remain poorly understood.”
