PURPOSE: The primary aim was to compare postoperative complications at 90 days and 1 year following trigger finger release (TFR) in patients with versus without glucagon-like peptide-1 receptor agonist (GLP-1 RA) exposure. GLP-1 RAs are increasingly used for managing diabetes and obesity. These drugs' impact on surgical outcomes, particularly wound healing and fibrosis, is not well understood.
METHODS: A retrospective matched cohort study was conducted using the TriNetX US Collaborative Network. Patients undergoing TFR were stratified by GLP-1 RA exposure within 1 year before or after surgery. Propensity score matching was applied to balance demographics, metabolic risk factors, and comorbidities. Primary outcomes included rates of scarring, postoperative pain, wound complications, and repeat TFR at both 90 days and 1 year.
RESULTS: Each cohort included 4,283 matched patients. GLP-1 RA exposure was associated with significantly increased risk of scarring (90 days: 1.5% vs 0.9%, 1 year: 2.3% vs 1.5%), postoperative pain (90 days: 13.2% vs 10.6%, 1 year: 21.6% vs 16.9%), and wound complications (90 days: 1.7% vs 0.9%, 1 year: 2.3% vs 1.4%). Repeat TFR was significantly higher only at 1 year (11.4% vs 9.5%). There were no significant differences in infection rates, systemic complications, or health care utilization at either timepoint.
CONCLUSIONS: GLP-1 RA use is independently associated with increased risks of postoperative pain, scarring, wound complications, and repeat surgery following TFR. The delayed increase in repeat TFR suggests a possible long-term effect on tendon or wound healing that warrants further investigation.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic III.
