Outcomes of Unicompartmental Knee Arthroplasty in Patients Receiving Glucagon-like Peptide 1 Agonist Therapy: A Matched Cohort Study

TL;DR

This study found that using GLP-1 agonists in patients undergoing knee surgery does not increase surgical risks and may reduce hospital stays.

Contribution

The study is the first to investigate the impact of GLP-1 agonists on outcomes of unicompartmental knee arthroplasty using a matched cohort design.

Findings

GLP-1 agonist users had no increased risk of surgical site or prosthetic joint infections.

Patients on GLP-1 agonists had shorter hospital stays (≥3 days) after surgery.

No significant differences in complications were observed at one year post-surgery.

Abstract

Unicompartmental knee arthroplasty (UKA) has become increasingly utilized to treat single-compartment osteoarthritis, including in patients with type 2 diabetes mellitus (T2DM). Glucagon-like peptide-1 (GLP-1) agonists have revolutionized T2DM management and are also widely prescribed for managing obesity. Limited data currently exist on their impact on UKA outcomes. Therefore, this study investigated UKA outcomes in patients receiving GLP-1 agonists.

Adult patients with T2DM and/or obesity undergoing UKA between 2009 and 2022 were identified utilizing an administrative claims database. Patients who were prescribed GLP-1 agonists within 6 months before surgery were 1:4 propensity score matched to controls based on age, sex, comorbidity burden, obesity class, and T2DM status. Multivariable logistic regressions were employed to examine 90-day and 1-year UKA outcomes between groups.

Of the 26,271 patients who underwent UKA, matching yielded 1018 GLP-1 agonist users and 4493 controls. There were no significant differences in 90-day surgical site infections (odds ratio [OR] 0.9; P = .79) or prosthetic joint infections (OR 0.7; P = .40). Patients on GLP-1 agonists had decreased odds of extended hospital length of stay (≥3 days) (OR 0.6; P < .001). There were no significant differences in complications at 1 year after surgery.

Our study showed that patients receiving GLP-1 agonists did not have increased rates of adverse surgical outcomes following UKA; however, we could not definitively conclude that GLP-1 agonists served as a protective factor for decreasing complications. Given the expanding usage of GLP-1 agonists, prospective research is needed to delineate these potential risks or benefits.

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