Lawand Jad J, Tansey Patrick J, Ghali Abdullah, Tye Cooper, Hantouly Ashraf, Fares Mohamad Y, Khan Adam Z, Somerson Jeremy S, Abboud Joseph A
John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA.
Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX, USA.
J Shoulder Elbow Surg. 2025 May;34(5):1152-1157. doi: 10.1016/j.jse.2024.09.012. Epub 2024 Nov 9.
Glucagon-like peptide-1 (GLP-1) receptor agonists, increasingly used for diabetes management and weight loss, have been linked to lower readmission rates after knee and hip arthroplasty. However, their impact on total shoulder arthroplasty (TSA) outcomes remains unclear. This study investigates the effects of GLP-1 receptor agonists on major complications and revisions following TSA.
A retrospective query of the TriNetX database from 2010 to 2023 was performed to identify patients who underwent anatomic or reverse TSA and were prescribed GLP-1 receptor agonists. GLP-1 receptor agonist users were 1:1 propensity score-matched to controls for demographic factors and comorbidities, yielding 1259 patients in each group. Outcomes included 90-day postoperative medical complications and readmission and revision surgery at 2 years. Odds ratios (ORs), 95% confidence intervals, and P values were calculated. After Bonferroni correction, P < .005 was considered significant.
GLP-1 receptor agonist users (n = 1259) experienced significantly higher rates of deep vein thrombosis (1.6% vs. 0.9%; OR 3.0; P = .001), myocardial infarction (1.60% vs. 0.9%; OR 2.84; P = .003), pneumonia (3.34% vs. 1.50%; OR 2.25; P = .003), transfusion (7.1% vs. 4.3%; OR 1.7; P = .003), and readmission (8.1% vs. 5.2%; OR 1.6; P = .004) in the 90-day postoperative period compared to patients not taking GLP-1 receptor agonists. There were no differences in the rates of stroke, pulmonary embolism, postoperative anemia, or renal failure. In patients with a minimum 2-year follow-up (n = 776), there was no difference in revision rate (3.2% vs. 1.8%; OR 1.8; P = .07).
GLP-1 receptor agonist use during TSA was associated with an increased risk of deep vein thrombosis, myocardial infarction, pneumonia, need for transfusion, and readmission. Further investigation into the perioperative risk assessment and medical optimization of patients utilizing GLP-1 receptor agonists may be warranted.
胰高血糖素样肽-1（GLP-1）受体激动剂越来越多地用于糖尿病管理和减肥，与膝关节和髋关节置换术后较低的再入院率有关。然而，它们对全肩关节置换术（TSA）结果的影响仍不清楚。本研究调查了GLP-1受体激动剂对TSA术后主要并发症和翻修手术的影响。
对2010年至2023年的TriNetX数据库进行回顾性查询，以识别接受解剖型或反向TSA并被处方GLP-1受体激动剂的患者。GLP-1受体激动剂使用者按1:1倾向评分与对照组在人口统计学因素和合并症方面进行匹配，每组产生1259例患者。结果包括术后90天的医疗并发症、再入院以及2年时的翻修手术。计算比值比（OR）、95%置信区间和P值。经过Bonferroni校正后，P <.005被认为具有统计学意义。
与未使用GLP-1受体激动剂的患者相比，GLP-1受体激动剂使用者（n = 1259）在术后90天内发生深静脉血栓形成的比率显著更高（1.6%对0.9%；OR 3.0；P =.001）、心肌梗死（1.60%对0.9%；OR 2.84；P =.003）、肺炎（3.34%对1.50%；OR 2.25；P =.003）、输血（7.1%对4.3%；OR 1.7；P =.003）和再入院（8.1%对5.2%；OR 1.6；P =.004）。中风、肺栓塞、术后贫血或肾衰竭的发生率没有差异。在至少随访2年的患者（n = 776）中，翻修率没有差异（3.2%对1.8%；OR 1.8；P =.07）。
TSA期间使用GLP-1受体激动剂与深静脉血栓形成、心肌梗死、肺炎、输血需求和再入院风险增加相关。可能有必要对使用GLP-1受体激动剂的患者进行围手术期风险评估和医疗优化的进一步研究。
