USA: A large health records analysis has revealed that people with knee osteoarthritis who used GLP-1 receptor agonists were less likely to undergo knee replacement surgery. Longer exposure to GLP-1 therapy was associated with progressively lower arthroplasty rates. While the findings may reflect benefits related to weight loss, the reasons for starting GLP-1 treatment and changes in body weight over time were not assessed, leaving the underlying mechanisms unclear.

The findings were published in Regional Anesthesia and Pain Medicine by Victoria Carter and colleagues from the University of Maryland School of Medicine.
Knee osteoarthritis is a major cause of chronic pain and disability, with total knee arthroplasty (TKA) often required for advanced disease. As no approved therapies currently slow disease progression, researchers examined whether GLP-1 receptor agonists (GLP-1 RAs), commonly used for diabetes and obesity, could reduce the need for knee replacement surgery.
Using the TriNetX Global Research Network, the team analyzed adults diagnosed with knee osteoarthritis between 2010 and 2024. Patients treated with GLP-1 RAs, including semaglutide and tirzepatide, were compared with matched non-users. Treatment exposure was evaluated at one and three years, and the risk of TKA was assessed over follow-up periods of up to eight years.
After matching for demographic, clinical, and healthcare access factors, study cohorts ranged from 13,351 to 42,062 patients. Across all analyses, GLP-1 receptor agonist use was associated with a significantly lower risk of knee replacement surgery compared with non-use.
The following were the key findings:
  • GLP-1 receptor agonist use was associated with a lower long-term risk of total knee arthroplasty (TKA).
  • One year of GLP-1 receptor agonist treatment reduced TKA risk by 2.8 percentage points at eight years.
  • Newer GLP-1 agents showed greater benefits than earlier-generation therapies.
  • Longer treatment duration was associated with greater reductions in knee replacement risk.
  • Three years of semaglutide or tirzepatide use was associated with a 4.71 percentage-point reduction in TKA risk at eight years.
  • Semaglutide and tirzepatide produced the largest reduction in arthroplasty risk among the therapies evaluated.
  • The protective association increased with both treatment duration and use of newer-generation GLP-1 receptor agonists.
  • The findings suggest that GLP-1 receptor agonists may have benefits beyond weight loss, including potential anti-inflammatory and cartilage-protective effects.
The researchers noted that the observational study design cannot prove causality. As data on treatment adherence, dosing, prescribing reasons, and weight changes were unavailable, it remains unclear whether the reduced knee replacement risk was due to weight loss, direct joint effects, or a combination of both.
The authors concluded that GLP-1 receptor agonists may represent a promising non-surgical option for knee osteoarthritis, particularly in patients with obesity or metabolic disease. However, prospective clinical trials are needed to confirm these findings and determine whether these drugs can slow disease progression and delay knee replacement surgery.
Reference:
Carter V, Desverreaux E, Amin I, et alGlucagon-like peptide 1 receptor agonist use and risk of arthroplasty for knee osteoarthritis: retrospective database analysis. Regional Anesthesia & Pain Medicine Published Online First: 02 June 2026. doi: 10.1136/rapm-2026-107658


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Article Source : Regional Anesthesia and Pain Medicine

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Medha Baranwal

Medha Baranwal holds a Bachelor’s degree in Biomedical Sciences from the University of Delhi and a Master’s degree in Biotechnology from Amity University. Since May 2018, she has been contributing to Medical Dialogues, writing and editing medical news articles that translate complex research into clear, accessible information for healthcare professionals.

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