Short-term complications in elective joint reconstruction: A retrospective assessment of the impact of GLP-1 agonists

Background: Total hip and knee arthroplasties (THA and TKA) are pivotal in treating joint disorders refractory to conservative management. In the United States, osteoarthritis linked to the growing elderly population and the obesity-driven rise in osteoarthritis. The rising use of Glucagon-like peptide 1 (GLP-1) agonists for weight loss management has come with reports of their short-term gastrointestinal (GI) side effects. This study examines the risk of short-term GI effects for THA and TKA patients with active GLP-1 prescriptions. Methods: A retrospective analysis was performed using the PearlDiver Mariner10 dataset from 2010 to 2022. Patients undergoing total hip or knee arthroplasty were identified and stratified by GLP-1 agonist use within 90 days prior to surgery. Data analyses involved Chi-square tests and multivariable logistic regression analyses. Results: A total of 83,587 THA and 150,099 TKA patients were studied, with 667 THA and 1876 TKA patients using GLP-1 agonists. TKA patients on GLP-1 agonists had higher gastroesophageal reflux rates (p < 0.001) and up to 17 % increased odds of reflux 90 days post-surgery. The use of GLP-1 agonists was linked to 31 % higher odds of GI ulcers at 30 days post-TKA (p = 0.010). GLP-1 agonists were associated with reduced constipation risk by 10–30 % in both cohorts. Conclusions: Use of GLP-1 agonists was significantly associated with certain short-term GI complications post-elective joint arthroplasty, particularly increased risk of ulcers, ileus, cholecystitis, gastroesophageal reflux, and diarrhea. The results underscore the importance of developing tailored perioperative care strategies for patients on GLP-1 agonists to minimize these risks.