GLP-1 RAs may reduce adverse effects in morbidly obese TKA patients: Study

A new study published in The Journal of Bone and Joint Surgery showed that when glucagon-like peptide-1 receptor agonist (GLP-1 RAs) are used during total knee arthroplasty (TKA), morbidly obese individuals (BMI ≥40 kg/m2) may experience fewer problems.

The results from weight optimization techniques for patients having total knee arthroplasty who are morbidly obese and have a body mass index (BMI) of ≥40 kg/m2 have been inconsistent. In order to assess the impact of perioperative glucagon-like peptide-1 receptor agonist usage in patients having primary total knee arthroplasty who had a BMI of ≥40 kg/m2, Billy Kim and his colleagues undertook this study.

The participants with morbid obesity going through primary TKA were matched based on their Charlson Comorbidity Index (CCI), age, gender, and diagnosis of type-2 diabetes mellitus. They were stratified into two groups where one used GLP-1 RA for 3 months prior to and following the procedure (treatment group) and the other who did not use it (control group) using an administrative claims database. Furthermore, a cohort of TKA patients with a BMI between 35.0 and 39.9 kg/m2 was compared to these groups. The matched groups were compared in terms of infection, complications, revision, and readmission.

The patients with a BMI of ≥40 kg/m2 who were taking GLP-1 RA experienced significantly lower rates of 90-day periprosthetic joint infection (PJI) (1.0% compared to 1.8%; p = 0.037), any medical complications (10.6% compared to 12.7%; p = 0.033), pulmonary embolism (<0.4% compared to 0.6%; p = 0.050), and readmissions (5.3% compared to 8.9%; p < 0.001) than those who were not on the medication.

The 2-year incidence of surgical complications did not differ between these groups (p > 0.05). Patients with a BMI of ≥40 kg/m2 who were taking a GLP-1 RA did not have higher incidence of infection or 90-day or 2-year sequelae when compared to obese patients (BMI of 35.0 to 39.9 kg/m2) (p > 0.05).

Overall, the patients with a BMI of ≥40 kg/m2 who received GLP-1 RA for at least 90 days before and after primary TKA had lower chances of 90-day PJI, any medical problems, and readmission. The decreased risk of complications was comparable to those of obese patients receiving TKA with a BMI between 35.0 and 39.9 kg/m2.

Source:

Kim, B. I., LaValva, S. M., Parks, M. L., Sculco, P. K., Della Valle, A. G., & Lee, G.-C. (2024). Glucagon-Like Peptide-1 Receptor Agonists Decrease Medical and Surgical Complications in Morbidly Obese Patients Undergoing Primary TKA. In Journal of Bone and Joint Surgery. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.2106/jbjs.24.00468