CureusDec 24, 2025

Lowering Joint Infection Risk After Surgery in Obese Patients Using GLP-1 Receptor Agonists

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jan 20, 2026

Abstract

Perioperative GLP-1 therapy in patients undergoing total hip arthroplasty is associated with an absolute risk reduction of approximately 1.8% for periprosthetic joint infection (PJI).

The analysis included eight cohorts with a total of 95,503 individuals, among which 22,098 were GLP-1 users.
Patients receiving GLP-1 therapy demonstrated fewer 90-day hospital readmissions compared to those not receiving the therapy.
No significant reduction in PJI incidence was found for total knee arthroplasty or for revision procedures.
GLP-1 therapy did not correlate with increased rates of serious complications such as venous thromboembolism or acute kidney injury.
The certainty of evidence was moderate for hip PJI and readmission outcomes, but low for knee PJI and revision outcomes.

Simplified

Obesity is a well-established risk factor for perioperative morbidity, including periprosthetic joint infection (PJI) and unplanned readmission following total hip and knee arthroplasty. Glucagon-like peptide-1 (GLP-1) receptor agonists induce clinically meaningful weight loss and metabolic optimisation, yet their perioperative influence in arthroplasty populations remains uncertain. In this systematic review and meta-analysis of observational cohorts comprising adults with obesity undergoing primary hip or knee arthroplasty, outcomes were compared between patients receiving perioperative GLP-1 therapy and those not exposed to these agents. Eight cohorts encompassing 95,503 individuals, including 22,098 GLP-1 users, met inclusion criteria. Perioperative GLP-1 therapy was associated with a significantly reduced incidence of PJI after total hip arthroplasty and fewer 90-day hospital readmissions, corresponding to an absolute risk reduction of approximately 1.8% from a median baseline risk of 9% and an estimated number needed to treat of 56. No significant association was demonstrated for PJI following total knee arthroplasty or for revision procedures, and GLP-1 therapy was not linked to increased rates of venous thromboembolism, acute kidney injury, cerebrovascular events, myocardial infarction, or hypoglycaemia. Certainty of evidence was moderate for hip PJI and readmission and low for knee PJI and revision outcomes. These findings suggest that perioperative GLP-1 therapy may confer clinically relevant benefits in selected arthroplasty populations, underscoring the need for well-designed randomised trials to define optimal perioperative protocols, economic value, and long-term implant survivorship.

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Lowering Joint Infection Risk After Surgery in Obese Patients Using GLP-1 Receptor Agonists

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