North Texas Research Forum 2025
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Division
North Texas
Hospital
Medical City Denton
Specialty
Orthopedic Surgery
Document Type
Presentation
Publication Date
2025
Keywords
total knee arthroplasty, TKA, GLP-1 receptor agonist, knee surgery, Glucagon-like peptide-1 agonist, obesity
Disciplines
Medicine and Health Sciences | Orthopedics | Surgical Procedures, Operative
Abstract
Objective: Total knee arthroplasty (TKA) is one of the most common elective orthopaedic surgeries. In addition, there are rising rates of obesity and diabetes and, with it, medications to treat them. This retrospective cross-sectional analysis aims to examine the outcomes of patients who underwent TKA and were on a Glucagon-like peptide-1 agonist (GLP-1a) at the time of surgery Methods: This study analyzes a database using CPT and ICD-10 codes to identify patients having primary TKA for knee osteoarthritis. Patients were divided into two groups based on GLP-1a use at TKA. Control variables included sex, age, BMI, smoking status, ECI, and type 2 diabetes. Primary outcomes included surgical site infection (SSI) within 90 and 365 days, medical complications within 30 days, 90-day readmissions, implant complications, revision TKA, in-hospital mortality or discharge to hospice within 365 days, and initial hospital stay length. A sub-analysis focused on diabetic and non-diabetic populations and compared those taking semaglutide, dulaglutide, or liraglutide with non-GLP-1a users. Results: Results: 26,157 patients met inclusion criteria; 914 were on GLP-1a (668 diabetic, 246 non-diabetic). GLP-1a users were younger and had a higher BMI in both groups (p < 0.001 for diabetics, p = 0.001 for non-diabetics). Logistic regression showed GLP-1a use correlated with a 10% reduction in hospital stay (p < 0.0001) and 45% lower odds of 1-year implant complications (p = 0.0195). Among diabetics, GLP-1a use did not affect 30, 90, or 365-day outcomes. Non-diabetics using GLP-1a showed increased rates of 30-day AKI (p = 0.001), medical complications (p = 0.002), and 1-year readmissions (p = 0.007), but lower rates of 1-year revision TKA (p = 0.016). Dulaglutide increased AKI and medical complications (p < 0.01) and semaglutide was linked to higher 1-year readmissions (p = 0.0008). Conclusions: The results of this retrospective cross-sectional analysis suggest GLP-1a use is associated with reduced hospital length of stay and lower odds of implant complications in all patients. Non-diabetic GLP-1a users demonstrated increased rates of certain short-term complications and readmissions. These findings indicate that GLP-1a can be beneficial in arthroplasty patients, but they are not without potential risks and individualized care should be taken in patients on GLP-1a undergoing surgery.
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Box, McKenna; Puga, Troy B.; Werthmann, Neil J.; Jen, Andrew M.; Liu, Yingxian; and Riehl, John T., "A Retrospective Cross-Sectional Study of GLP-1 Agonist Effects on Outcomes after Total Knee Arthroplasty" (2025). North Texas Research Forum 2025. 7.
https://scholarlycommons.hcahealthcare.com/northtexas2025/7