BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly utilized in managing type 2 diabetes mellitus (T2DM) and obesity. Emerging evidence suggests their role in enhancing bone metabolism, with potential implications for orthopedic outcomes.
PURPOSE: To evaluate the impact of perioperative GLP-1RA use on outcomes following midfoot arthrodesis.
STUDY DESIGN: This retrospective cohort study used the TriNetX U.S. Collaborative Network to evaluate outcomes following midfoot fusion in patients with versus without perioperative GLP-1RA use.
METHODS: Patients were propensity score matched (1:1) for key demographic and clinical variables. Primary outcomes included 90-day and 1-year surgical complications, nonunion, and mechanical issues. Logistic regression models were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: Among 1,504 matched patients (752 per cohort), GLP-1RA use was associated with significantly reduced odds of nonunion at 1 year (OR = 0.712; 95% CI = 0.52-0.958). However, GLP-1RA users had higher 90-day rates of wound complications (OR = 1.713, 95% CI = 1.141-2.57), irrigation and debridement (OR = 1.873; 95% CI = 1.223-2.869), and elevated 1-year mechanical complications rates (OR = 2.446; 95% CI = 1.552-3.857). No significant differences were observed in infection rates or overall hospital admissions.
CONCLUSION: There is an observed association with perioperative GLP-1RA use and lower nonunion rates following midfoot arthrodesis, indicating a potential benefit for bone healing. However, increased mechanical and wound-related complications warrant further investigation into their surgical safety profile in foot and ankle procedures.
