Preoperative GLP-1 Receptor Agonist Use Improves Thromboembolic, Infectious, and Wound-Related Outcomes Following Unicompartmental Knee Arthroplasty

Q: What are the key findings of this study?

Preoperative GLP-1 receptor agonist use was associated with a 75% relative risk reduction in 90-day deep vein thrombosis and lower rates of infectious and wound-related complications following unicompartmental knee arthroplasty.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Unicompartmental knee arthroplasty (n=2276). Intervention: Preoperative GLP-1 receptor agonist vs. Non-users. Primary outcome: 90-day deep vein thrombosis (RRR 75%, 95% CI 15-93, p=0.013).

Q: What does this research mean for the field?

Preoperative GLP-1 receptor agonist use is associated with significantly reduced rates of deep vein thrombosis, surgical site infections, wound complications, and 2-year prosthetic joint infections following unicompartmental knee arthroplasty. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Zachary Fuller; Manjot Singh; Abhiram Dawar; Jeremiah Thomas; Alan H. Daniels; Zuhdi E. Abdo

doi:10.60118/001c.162883

September 24, 2026Journal of Orthopaedic Experience & InnovationOpen Access

Preoperative GLP-1 Receptor Agonist Use Improves Thromboembolic, Infectious, and Wound-Related Outcomes Following Unicompartmental Knee Arthroplasty

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Key result

Preoperative GLP-1RA use is linked to ~75% lower 90-day DVT risk after unicompartmental knee arthroplasty.

RRR 75%
95% CI 15-93
P=0.013
n=2,276

Why the study?

Does preoperative GLP-1 receptor agonist use reduce postoperative complications in adult patients undergoing primary unicompartmental knee arthroplasty?

Key Points

To evaluate the association between preoperative GLP-1 receptor agonist use and postoperative complication rates following unicompartmental knee arthroplasty.
Queried a national claims database from 2010 to 2021 to identify patients undergoing primary unicompartmental knee arthroplasty.
Performed 1:1 propensity matching based on age, sex, Charlson Comorbidity Index, diabetes, obesity, and tobacco use, yielding two matched cohorts of 1,138 patients each (mean age 61.1 years, 53% female).
Compared 90-day and 2-year postoperative outcomes using chi-square tests, reporting relative risk reduction (RRR) and 95% confidence intervals.
At 90 days, GLP-1 users had significantly lower rates of deep vein thrombosis (0.4% vs. 1.4%; RRR = 75%; 95% CI: 15-93%; P = 0.013), wound complications (0.0% vs. 1.2%; RRR = 100%; P < 0.001), and surgical site infections (0.1% vs. 1.2%; RRR = 93%; 95% CI: 34-99%; P = 0.002).
At 2 years, GLP-1 users demonstrated significantly lower rates of prosthetic joint infection (0.4% vs. 1.4%; RRR = 75%; 95% CI: 15-93%; P = 0.013).
All-cause revision surgery rates at 2 years trended lower among GLP-1 users but did not reach statistical significance (2.3% vs. 3.6%; RRR = 37%; P = 0.083).

Study Design

Type

Cohort (n=2,276)

Multicenter

Yes

Structured PICO

Does preoperative GLP-1 receptor agonist use reduce postoperative complications in adult patients undergoing primary unicompartmental knee arthroplasty?

P

Population

2,276 adult patients undergoing primary unicompartmental knee arthroplasty, propensity-matched for comorbidities including diabetes and obesity, followed for up to 2 years.

E

Exposure

Preoperative GLP-1 receptor agonist use (exenatide, liraglutide, dulaglutide, semaglutide, tirzepatide) within 1 year prior to surgery.

C

Comparator

Non-users of GLP-1 agonists, 1:1 propensity-matched based on age, sex, Charlson Comorbidity Index, diabetes, obesity, and tobacco use.

O

Outcome

90-day complications (acute kidney injury, deep venous thrombosis, pulmonary embolism, wound complications, surgical site infection, hematoma, transfusion requirements, urinary tract infection, and 90-day readmissions) and 2-year implant-related complications (aseptic loosening, instability/dislocation, mechanical failure, periprosthetic fracture, osteolysis, prosthetic joint infection, and all-cause revisions).safety

Main Result

Effect estimate: RRR 75% (95% CI 15-93)

Absolute Event Rate: 0.4% vs 1.4%

p-value: p=0.013

Preoperative GLP-1 receptor agonist use is associated with significantly lower rates of thromboembolic, infectious, and wound-related complications following unicompartmental knee arthroplasty.

Limitations

Retrospective nature of administrative database studies limits causal inference and unmeasured confounding cannot be completely excluded.
Inability to analyze individual GLP-1 agents, dosing regimens, or duration of therapy.
Lack of data on medication adherence or whether patients continued GLP-1 therapy postoperatively.
Unavailability of clinical variables such as HbA1c levels, body mass index changes, or other metabolic parameters.
High prevalence of diabetes in the cohort may limit generalizability to non-diabetic populations.
Retrospective nature of administrative database studies inherently limits causal inference
Dataset does not permit analysis of individual GLP-1 agents, dosing regimens, or duration of therapy
Important clinical variables such as HbA1c levels, body mass index changes, or other metabolic parameters were unavailable
Selection bias may exist regarding which patients receive GLP-1 prescriptions
High prevalence of diabetes in cohort may limit generalizability to non-diabetic populations

Implication

Preoperative GLP-1 use was associated with fewer UKA complications; hypothesis-generating and should not yet change practice.

Abstract

Background Glucagon-like peptide-1 (GLP-1) receptor agonists have demonstrated benefits in diabetes and obesity management, but their impact on outcomes following unicompartmental knee arthroplasty (UKA) remains unexplored. This study evaluates the influence of preoperative GLP-1 agonist use on postoperative complications following UKA. Methods A national claims database was queried to identify patients undergoing primary UKA between 2010 and 2021. Patients with preoperative GLP-1 prescriptions were 1:1 propensity-matched to non-users based on age, sex, Charlson Comorbidity Index, diabetes, obesity, and tobacco use, yielding two balanced cohorts of 1,138 patients each (mean age 61.1 years, 53% female). Successful matching was confirmed with standardized mean differences <0.001 for all variables. Primary outcomes included 90-day and 2-year complications. Categorical variables were compared using chi-square tests with relative risk reduction (RRR) and 95% confidence intervals. Results At 90 days, GLP-1 users demonstrated significantly lower rates of deep vein thrombosis (0.4% vs. 1.4%; RRR = 75%; 95% CI: 15-93%; P = 0.013), wound complications (0.0% vs. 1.2%; RRR = 100%; P < 0.001), and surgical site infections (0.1% vs. 1.2%; RRR = 93%; 95% CI: 34-99%; P = 0.002) compared to non-users. No significant differences were observed in pulmonary embolism, acute kidney injury, urinary tract infection, hematoma, transfusion requirements, or readmissions. At 2 years, GLP-1 users had significantly lower rates of prosthetic joint infection (0.4% vs. 1.4%; RRR = 75%; 95% CI: 15-93%; P = 0.013). All-cause revision rates showed a favorable trend in GLP-1 users but did not reach statistical significance (2.3% vs. 3.6%; RRR = 37%; P = 0.083). Conclusion Preoperative GLP-1 receptor agonist use was associated with lower rates of thromboembolic, infectious, and wound-related complications following UKA without an observed increase in other adverse events. These findings may reflect both medication-related effects and broader improvements in metabolic optimization. Prospective studies with detailed metabolic data are needed to further evaluate these associations.

Discussion

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Cite This Study

Fuller et al. (2026) conducted a cohort in Unicompartmental knee arthroplasty (n=2,276). Preoperative GLP-1 receptor agonist vs. Non-users was evaluated on 90-day deep vein thrombosis (RRR 75%, 95% CI 15-93, p=0.013). Preoperative GLP-1 receptor agonist use was associated with a 75% relative risk reduction in 90-day deep vein thrombosis and lower rates of infectious and wound-related complications following unicompartmental knee arthroplasty.

synapsesocial.com/papers/6ab9b4fa7822ec8fc3d8f40e https://doi.org/10.60118/001c.162883

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Preoperative GLP-1 Receptor Agonist Use Improves Thromboembolic, Infectious, and Wound-Related Outcomes Following Unicompartmental Knee Arthroplasty

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Preoperative GLP-1 Receptor Agonist Use Improves Thromboembolic, Infectious, and Wound-Related Outcomes Following Unicompartmental Knee Arthroplasty

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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