Glucagon-Like Peptide-1 Receptor Agonists, Readmission, and Postoperative Complications in Arthroplasty: A Systematic Review and Meta-Analysis.

Abstract

Agonists targeting the glucagon-like peptide-1 receptor have gained prominence in treating individuals who have type 2 diabetes and obesity. However, their influence on postoperative medical complications following total joint arthroplasty remains poorly characterized. A systematic review and meta-analysis were conducted using data from eight retrospective cohort studies encompassing 76,091 patients who underwent total hip or knee arthroplasty. The primary outcome was hospital readmission within 90 days. Additional postoperative events assessed included deep vein thrombosis, pulmonary embolism, pneumonia, acute kidney injury, surgical site infection, cerebrovascular accident, urinary tract infection, and hypoglycemic event. Pooled odds ratios were calculated using a random-effects model to account for interstudy variability. Patients who received glucagon-like peptide-1 receptor agonists (GLP-1 RAs) before surgery exhibited a significantly lower likelihood of 90-day readmission (odds ratio 0.73; 95% confidence interval: 0.64 to 0.82). There were no statistically significant differences observed in other postoperative medical complications. Sensitivity and trim-and-fill analyses revealed modest variability in select outcomes, but did not substantially alter overall conclusions. Preoperative GLP-1 RA use may be linked to reduced readmission risk following joint arthroplasty, without evidence of increased postoperative medical harm. Further prospective studies are warranted to validate these associations and guide perioperative care protocols.