The Effect of Glucagon-like Peptide-1 Receptor Agonists in Total Joint Arthroplasty: Implications, Complications, and Considerations

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GLP-1 receptor agonists present specific perioperative implications, complications, and clinical considerations for anesthesiologists and surgeons managing patients undergoing total joint arthroplasty. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Kristen I. Barton; Riley J. Boyle; Douglas A. Dennis; Jason M. Jennings

doi:10.5435/jaaos-d-25-00892

September 1, 2026Journal of the American Academy of Orthopaedic Surgeons

The Effect of Glucagon-like Peptide-1 Receptor Agonists in Total Joint Arthroplasty: Implications, Complications, and Considerations

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Key Points

To critically appraise current evidence on the perioperative pharmacology, adverse effects, and clinical management of GLP-1 receptor agonists in patients undergoing total joint arthroplasty.
Narrative review synthesizing evidence on the physiology, mechanisms of action, and pharmacology of common GLP-1 receptor agonists.
Evaluation of perioperative complications, adverse effects, and safety considerations specifically relevant to orthopedic surgeons and anesthesiologists.
Compilation and appraisal of clinical practice recommendations updated for 2025.
Widespread adoption of GLP-1 receptor agonists for diabetes and weight management introduces unique perioperative challenges, notably altered gastrointestinal motility that impacts anesthetic safety.
Effective perioperative management requires coordinated protocols between anesthesiologists and surgical teams to optimize glycemic status while mitigating pulmonary aspiration risks.
Updated 2025 clinical recommendations outline clear preoperative medication timing and perioperative surveillance strategies for joint replacement candidates.

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Implication

Clinical review evaluates perioperative risks of GLP-1 receptor agonists in total joint arthroplasty patients, highlighting updated anesthetic and surgical management guidelines.

Abstract

Glucagon-like peptide 1 (GLP-1) receptor agonists (GLP-1 RAs) are used in diabetic patients for glycemic control. Yet, there has been a notable rise in their use for weight loss management in obese patients. This review critically appraises current evidence on perioperative implications of GLP-1 receptor agonists in TJA patients. The review discusses GLP-1 RA implications and use (physiology, pharmacology, pharmacodynamics, mechanisms of actions, and commonly used GLP-1 Ras), complications and adverse effects, considerations for the anesthesiologist, considerations for the TJA surgeon, and current clinical practice recommendations in 2025.

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Cite This Study

Barton et al. (2026) studied this question.

synapsesocial.com/papers/6a993547636c6408cfa7d70b https://doi.org/10.5435/jaaos-d-25-00892

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The Effect of Glucagon-like Peptide-1 Receptor Agonists in Total Joint Arthroplasty: Implications, Complications, and Considerations

Key Points

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Implication

Abstract

Discussion

Cite This Study

The Effect of Glucagon-like Peptide-1 Receptor Agonists in Total Joint Arthroplasty: Implications, Complications, and Considerations

Key Points

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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