Glucagon-Like Peptide-1 Agonists in Total Hip Arthroplasty: Complications, Readmissions, and Patient-Reported Outcomes
Robert James Magaldi, Sara Strecker, Dan Witmer
Abstract
Background: Obesity and diabetes, although increasingly common among the general population, are critical and modifiable preoperative medical comorbidities that should be managed appropriately before elective total hip arthroplasty. Glucagon-like peptide-1 (GLP-1) agonists represent a novel treatment option for orthopaedic surgeons in addressing both weight loss and diabetic control in the preoperative setting. As their popularity continues to increase, it is important to understand the implications, safety, and outcomes associated with GLP-1 agonist use among patients undergoing elective total joint arthroplasty. Methods: A retrospective matched cohort analysis was conducted on all THA performed a high-volume orthopaedic hospital between June 2016 and December 2022. A total of 66 patients taking GLP-1 agonists were identified and matched in a 1:2 ratio by age, sex, and body mass index. Length of stay, inpatient complications, emergency department (ED) visits, readmissions, and Hip Osteoarthritis Outcome Score for Joint Replacement outcome scores were compared between the two groups using chi-squared tests and Student t test. Results: The GLP-1 cohort experienced a markedly higher rate of inpatient postoperative nausea and vomiting (18.2% vs. 6.0%, P = 0.011). Although more patient's taking GLP-1 agonists returned to the ED for nausea and vomiting among the GLP-1 cohort, no notable differences in ED volume were found between the two groups. Furthermore, no differences were reported in race, ethnicity, laterally, length of stay, or readmissions between the two cohorts. Conclusion: Despite the elevated risk of early postoperative nausea and vomiting among total hip arthroplasty patients taking GLP-1 agonists, their use was not associated with any notable differences in the length of stay, readmission rates, or other complications, including urinary retention and venous thromboembolism. Future studies should assess the appropriate window to stop GLP-1 agonists preoperatively and to investigate complications and outcomes associated with the different drugs and their dosages.