14 Feb AAOS: Patients on Semaglutide Did Better After Total Hip Replacement Surgery

MedicalResearch.com Interview with:

Dr. Magruder

Matthew Magruder, MD PGY3
Orthopaedic Residency Program
Department of Orthopaedic Surgery and Rehabilitation
Maimonides Medical Center

MedicalResearch.com: What is the background for this study?

Response: The prevalence of obesity and diabetes mellitus has reached epidemic proportions. Approximately 37.3 million people in the United States, accounting for 11.3% of the total population, have diabetes, and 100.1 million, or 41.9%, of all US citizens are obese. Furthermore, these numbers are only projected to increase in the coming decades. This is an issue for orthopaedic surgeons because diabetes and obesity have consistently been demonstrated to be risk factors for complications following total joint replacements, especially total hip replacements. Therefore, we are in desperate need of new and more effective tools in mitigating the risk of poor outcomes in our joint replacement patients.

Semaglutide, and other GLP-1 agonists, are potentially a new tool that can be used to help decrease the risks following joint replacement surgery. Initially a medication to treat diabetes, semaglutide has recently been approved by the FDA to treat obesity as well, as randomized controlled trials have consistently demonstrated significant weight loss with minimal side effects. The purpose of our study was to see what effect the use of semaglutide had on total hip arthroplasty patient outcomes.

MedicalResearch.com: What are the main findings?

Response:  The main findings of our study were that patients who underwent total hip arthroplasty who were taking semaglutide at the time of surgery had lower rates of prosthetic joint infections and readmissions within 90 days of surgery than those who were not taking semaglutide. Furthermore, there were no other differences in postoperative complications within 90 days between the two groups.

MedicalResearch.com: What should readers take away from your report?

Response: At this time, no study has evaluated optimal durations of treatment, optimal weight loss prior to or following surgery, or the appropriate medication schedule in the perioperative period with regard to semaglutide. These are all important questions that need to be answered and should be the focus of future studies. That being said, many anesthesiologists will require patients to hold their dose of semaglutide 1 week prior to surgery because there have been reports of aspiration when on the medication due to the drugs mechanism of action of slowing gastric emptying.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: We need prospective observational or randomized controlled trials which evaluate the safety and efficacy of semaglutide prior to joint replacement surgery in patients with diabetes and/or obesity.

Specifically, we need to understand

1) What is the most effective dosage and time on the medication prior to surgery,

2) What is the appropriate weight loss prior to surgery,

3) Which patients benefit the most from these medications,

4) iI semaglutide use in joint replacement surgery cost effectiveness.

Disclosures: I, nor any of my immediate family, have any conflicts of interest regarding the topic of this study.

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Last Updated on February 14, 2024 by Marie Benz MD FAAD