Key result
Preoperative GLP-1 RA use before hip arthroplasty is linked to ~47% lower 90-day DVT risk.
Why the study?
GLP-1 receptor agonists are increasingly prescribed among total hip arthroplasty candidates, but their perioperative impact remains unclear.
Does preoperative GLP-1 RA use reduce medical and mechanical complications in adults undergoing primary total hip arthroplasty?
Cohort (n=2,524)
Does preoperative GLP-1 RA use reduce medical and mechanical complications in adults undergoing primary total hip arthroplasty?
Relative Risk: 0.53 (95% CI 0.31–0.89)
Absolute Event Rate: 1.6% vs 3%
p-value: p=0.014
Preoperative GLP-1 RA use in patients undergoing total hip arthroplasty is associated with reduced 90-day DVT and hospital readmission rates without increasing mechanical complications.
GLP-1 RA use before THA was associated with lower 90-day DVT and readmission; hypothesis-generating and requires RCTs before practice change.
Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed among total hip arthroplasty (THA) candidates, yet their perioperative impact remains unclear. Methods: Using TriNetX, we identified adults undergoing primary THA (2003–2023) with preoperative GLP-1 RA exposure (⩾3 prescriptions within 1 year of surgery) versus controls. 1:1 propensity score matching for demographics, comorbidities, and baseline labs yielded 1262 patients per cohort. Outcomes included 90-day medical complications and mechanical complications (PJI, dislocation, aseptic loosening, periprosthetic fracture, all-cause revision) at 1, 2, and 5 years, reported in accordance with the STROBE guidelines. Results: At 90 days, the GLP-1 RA cohort demonstrated significantly lower risks of DVT (1.6% vs. 3.0%; RR 0.53, 95% CI, 0.31–0.89; p = 0.014) and hospital readmission (1.1% vs. 2.8%; RR 0.40, 95% CI, 0.22–0.71; p = 0.001). No significant differences were found in other 90-day outcomes or in mechanical complications, including all-cause revision (94.6% vs. 95.5% survival; p = 0.674) and PJI (94.7% vs. 94.4%; p = 0.465) at 5 years. Conclusions: Consistent preoperative GLP-1 RA use is associated with reduced 90-day DVT and readmission following primary THA without increased risk of other complications or mechanical outcomes at 5 years. As DVT was the only significant thromboembolic endpoint, prospective investigation is needed before attributing a thromboprophylactic effect to these agents.
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Diab et al. (2026) conducted a cohort in Total hip arthroplasty (n=2,524). GLP-1 receptor agonists vs. Controls (no GLP-1 RA exposure) was evaluated on 90-day deep vein thrombosis (DVT) (RR 0.53, 95% CI 0.31-0.89, p=0.014). Preoperative GLP-1 RA use before primary total hip arthroplasty was associated with a lower 90-day risk of DVT (1.6% vs. 3.0%; RR 0.53, 95% CI 0.31-0.89) and hospital readmission.
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