BACKGROUND: Rotator cuff tears occur with increased prevalence and worse outcomes in patients with diabetes mellitus. Glucagon-like peptide-1 receptor agonists (GLP-1RA) have demonstrated efficacy in improving glycemic control and reducing body weight, and early studies have examined their perioperative use in total shoulder arthroplasty.
PURPOSE: To investigate the association between GLP-1RA use and postoperative outcomes following arthroscopic rotator cuff repair (RCR).
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: A retrospective cohort study utilizing the TriNetX database identified patients undergoing arthroscopic RCR from 2000 to 2024. Patients prescribed GLP-1RA within 6 months preoperatively were compared with a propensity-matched cohort without GLP-1RA exposure. Primary outcomes included 90-day postoperative medical complications and 2-year surgical outcomes. Outcomes between cohorts were compared using odds ratios (ORs) with 95% CIs.
RESULTS: After propensity score matching, 3066 patients were included in each cohort. The GLP-1RA cohort had a significantly lower risk of hospital readmission within 90 days (2.7% vs 3.6%; OR, 0.741; 95% CI, 0.555-0.989;= .04) and reduced likelihood of subsequent RCR within 2 years (4.5% vs. 5.7%; OR, 0.768; 95% CI, 0.611-0.966;= .02). No significant differences were observed in surgical-site infection, pneumonia, thromboembolic events, or emergency department visits within 90 days postoperatively. Likewise, no differences were found in other surgical outcomes, including shoulder arthroplasty, lysis of adhesions, or adhesive capsulitis at the 2-year follow-up. P P
CONCLUSION: Preoperative GLP-1RA use for patients undergoing arthroscopic RCR was associated with a decreased risk of both hospital readmission at 90 days and subsequent RCR at 2 years postoperatively. There was no difference in the risk of shoulder arthroplasty, adhesive capsulitis, lysis of adhesions, or 90-day medical complications between groups. These findings suggest that GLP-1RA use appears safe in the perioperative period for patients undergoing arthroscopic RCR, providing reassurance for clinicians managing patients already prescribed these medications.
