BACKGROUND: Our study evaluated 90-day outcomes of patients treated preoperatively with glucagon-like peptide-1 receptor agonists (GLP-1) or bariatric surgery compared to no weight loss intervention prior to total hip arthroplasty (THA) and total knee arthroplasty (TKA).
METHODS: A multicenter institutional cohort of patients undergoing primary THA (n = 5710) and TKA (n = 6770) from 2023 to 2024 was identified. Preoperative weight-loss strategies included no intervention (89%), perioperative use of GLP-1 (10%), or prior bariatric surgery (1%). Ninety-day readmissions and reoperations were compared among groups. Subanalyses were performed stratifying obesity (body mass index) classification and diabetes mellitus status vs others to contextualize these independent risk factors.
RESULTS: Among all patients undergoing THA and TKA, those who had undergone bariatric surgery experienced significantly higher reoperation rates at 90 days compared to those without intervention and GLP-1 groups (2.2 vs 0.5 vs 0.8%, respectively;= .014). For THA, both the no intervention and GLP-1 groups had significantly lower readmission rates compared to the bariatric surgery group (4.4 vs 6.5 vs 8.8%, respectively;= .04) and lower reoperation rates (0.4 vs 1.4 vs 2.2%;= .006). For TKA, there were no significant differences in readmission (.47) or reoperation rates (≥ .067) among the groups or by body mass index class and diabetes mellitus status. P P P P P ≥
CONCLUSIONS: Compared to no weight loss intervention, patients utilizing perioperative GLP-1s demonstrated similar 90-day readmission and reoperation rates after primary THA and TKA. Those with prior bariatric surgery showed the greatest risk of readmission and reoperation, particularly after THA.
LEVEL OF EVIDENCE: IV, Retrospective Review.
