Effect of Glucagon-like Peptide-1 Receptor Agonist on Outcomes After Elective Total Hip Arthroplasty: A Retrospective Cohort Study

Division

North Texas

Hospital

Medical City Denton

Document Type

Manuscript

Publication Date

7-1-2026

Keywords

Humans, Arthroplasty, Replacement, Hip, Female, Retrospective Studies, Male, Aged, Elective Surgical Procedures, Postoperative Complications, Glucagon-Like Peptide-1 Receptor Agonists, Treatment Outcome, Middle Aged, Cohort Studies

Disciplines

Medicine and Health Sciences | Orthopedics | Surgical Procedures, Operative

Abstract

OBJECTIVE: To evaluate medical and surgical outcomes postoperatively for patients using GLP-1RA at the time of undergoing THA surgery, with a focus on early 30 day medical complications and 1 year surgical complications.

METHODS: This was a retrospective cohort study. Current Procedural Terminology (CPT) and International Classification of Diseases (ICD)-10 codes were utilized to identify patients. Patients were placed into two groups based on whether they were on a GLP-1RA or not. Sex, age, body mass index (BMI), smoking status, and Elixhauser comorbidity index (ECI) and diabetes status were control variables. Outcomes studied were surgical site infection (SSI), medical complications, all-cause readmissions, implant complications, revision THA, and in-hospital mortality or discharge to hospice.

RESULTS: 13,206 patients met inclusion criteria. 335 (2.5 %) patients were on a GLP-1RA. In both cohorts, GLP-1RA users were younger, had higher BMIs, and more comorbidities than those not on GLP-1RA (p < 0.05). At 30 days postoperatively patients taking GLP-1RA experienced higher rates of pulmonary embolism (PE) (p = 0.004), acute kidney injury (AKI) (p = 0.006), hypoglycemia (p < 0.001), and overall complications (p < 0.001) compared with patients not receiving GLP-1RA. However, when bivariate logistic regression analyses, controlling for age, sex, BMI, smoking status, ECI, and diabetes status was undertaken, GLP-1RA use was not associated with elevated risks of adverse outcomes at 30 days for medical complications (Odds Ratio (OR): 1.611; 95 % Confidence Interval (CI) 0.881-2.947, p = 0.1215). Bivariate logistic regression also revealed no difference in complications for 90 days readmission or SSI, and 1 year postoperative surgical outcomes or readmissions.

CONCLUSIONS: The results suggest that GLP-1RA use was not associated with any statistical difference in overall medical complications at 30 days, 90 day readmissions or SSI, or 1 year postoperative surgical outcomes when patients undergo THA while taking a GLP-1RA medication when controlling for confounding variables. GLP-1RA medications do not appear to be associated with increased risk of complications for patients undergoing THA, however, future studies can further evaluate if complications exist.

Publisher or Conference

Journal of Orthopaedic Surgery

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