Key result
GLP-1 receptor agonist use prior to rotator cuff repair was not associated with an increased risk of reoperation, though use for diabetes increased the 3-month risk of adhesive capsulitis (RR 2.20).
Why the study?
GLP-1 receptor agonist use is increasingly common among orthopaedic patients, but its impact on re-operation risk following rotator cuff repair needed evaluation.
Does GLP-1 receptor agonist use affect reoperation risk in patients undergoing rotator cuff repair?
Cohort (n=10,612)
Yes
Does GLP-1 receptor agonist use affect reoperation risk in patients undergoing rotator cuff repair?
GLP-1 receptor agonists can be safely continued prior to rotator cuff repair without increasing the risk of reoperation, though diabetic patients may have a higher short-term risk of adhesive capsulitis.
Objectives: The use of glucagon-like peptide-1 (GLP-1) receptor agonists is increasingly common among orthopaedic patients, often prescribed for type 2 diabetes mellitus and obesity, which are frequent comorbidities. Recent studies have explored the effects of GLP-1's on postoperative outcomes in orthopaedic procedures. This study evaluates the impact of GLP-1 on re-operation risk following rotator cuff repair (RCR). Methods: A retrospective cohort analysis of patients aged 18 and older from 2014 to 2024 was conducted using the TriNetX US collaborative network. Patients with documented RCR and no prior GLP-1 use were included in the control group. Those taking semaglutide, dulaglutide, or liraglutide for at least 3 months before RCR comprised the GLP-1 group. After comparing baseline characteristics, cohorts were matched based on selected covariates. Outcomes were compared using risk ratios (RR) with 95 % confidence intervals (CI). A subgroup analysis by GLP-1 indication (type 2 diabetes or weight loss) was performed. Results: Propensity score matching yielded well-balanced cohorts of 5306 patients. Subgroup analysis included 781 patients per group. At 3, 6, and 12 months post-RCR, the control group showed no difference in reoperation risk. In a sub-analysis of the GLP-1 group, those receiving it for diabetes, compared to obesity, showed an increased risk of adhesive capsulitis at 3 months (RR = 2.20, 95 % CI [1.05-4.62], P = 0.0321). Conclusion: The use of GLP-1 was not associated with a higher reoperation risk after RCR, suggesting that these medications can safely be taken leading up to RCR. However, increased short-term risks in diabetes patients highlight the need for individualized care and further study of GLP-1 effects on orthopaedic outcomes.
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Asif M. Ilyas (2025) conducted a cohort in Rotator cuff repair (n=10,612). GLP-1 receptor agonists (semaglutide, dulaglutide, or liraglutide) vs. No prior GLP-1 use was evaluated on Reoperation risk at 3, 6, and 12 months post-RCR. GLP-1 receptor agonist use prior to rotator cuff repair was not associated with an increased risk of reoperation, though use for diabetes increased the 3-month risk of adhesive capsulitis (RR 2.20).
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