What question did this study set out to answer?

The research aims to evaluate the effects of GLP-1 receptor agonist therapy on postoperative outcomes in patients with tibial plateau fractures.

April 17, 2026

Trimming the Fat: Does GLP-1 Receptor Agonist Therapy Impact Clinical and Functional Results After Tibial Plateau Fracture Fixation?

Puntos clave

The research aims to evaluate the effects of GLP-1 receptor agonist therapy on postoperative outcomes in patients with tibial plateau fractures.
Retrospective cohort study conducted at an urban academic institution.
Included patients with tibial plateau fractures from 2016-2024, followed for ≥6 months.
Compared GLP-1 users to non-GLP-1 cohorts stratified by BMI using statistical analyses with ANOVA and Chi-square tests.
GLP-1 users had a higher pre-injury osteoarthritis severity compared to non-GLP-1 groups.
Radiographic PTOA incidence was significantly higher in obese patients (Group D).
Final knee flexion ROM was significantly lower in obese patients versus GLP-1 users, but nonunions were higher in the GLP-1 group.

Resumen

Objectives: This study evaluated the impact of prolonged glucagon-like peptide-1 (GLP-1) receptor agonist use on postoperative outcomes, including radiographic post-traumatic osteoarthritis (PTOA), fracture nonunion, and final knee range of motion—following operative management of tibial plateau fractures across multiple BMI strata. Methods: A retrospective cohort study was conducted at an urban academic institution, including patients who underwent surgical fixation for tibial plateau fractures between 2016-2024, with a ≥6 months follow-up. The GLP-1 cohort consisted of patients with documented long-term GLP-1 use pre- and postoperatively. GLP-1 users (Group A, n=24) were compared to three non-GLP-1 cohorts stratified by BMI: Group B (BMI 18.5–25, n=150), Group C (BMI 25–30, n=150), and Group D (BMI ≥30, n=100). Outcomes included Kellgren–Lawrence osteoarthritis grade, post-reduction fracture angulation, articular step-off, Charlson Comorbidity Index (CCI), fracture complications (infection, nonunion, PTOA, revision surgery), and final knee flexion range of motion (ROM). Statistical analyses used SPSS Statistics version 29.0 (IBM Corp., Armonk, NY) with ANOVA and Chi-square tests. Results: Mean follow-up was 28.83 months. Baseline age, CCI, fracture angulation, and step-off were comparable between groups. Pre-injury osteoarthritis severity was higher in Group A (0.96±0.88) than in Groups B (0.68±0.86), C (0.54 ± 0.75), and D (0.78±0.74) (p<0.001). Radiographic PTOA incidence was highest in Group D (32%, p<0.01), while Group A rates were comparable to Groups B and C (p≈0.62). Final knee flexion ROM differed significantly (p<0.01), with Group D showing the lowest mobility (119.08±16.47°). Nonunion rates were significantly higher in Group A (p<0.01). Conclusions: Among obese patients, GLP-1 receptor agonist use was associated with a lower incidence of PTOA and preserved knee ROM compared to untreated obese individuals, with outcomes similar to non-obese patients. However, GLP-1 use was also linked to increased nonunion rates. These findings suggest that while GLP-1 therapy may mitigate obesity-related joint degeneration, it may also challenge fracture healing. Keywords: GLP-1 Receptor Agonist; Tibial Plateau Fracture; Nonunion

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