Al Basri Saif, Fenske Wiebke K
Allgemeine Innere Medizin, Endokrinologie und Diabetologie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland.
Orthopadie (Heidelb). 2025 Apr;54(4):278-282. doi: 10.1007/s00132-025-04609-8. Epub 2025 Feb 3.
The increasing prevalence of obesity represents a significant and growing challenge in orthopaedic surgery. This is particularly true for patients with morbid obesity, who have a significantly increased risk of postoperative complications. The newer incretin-based therapies (such as semaglutide and tirzepatide), these so-called "weight loss injections", offer promising potential for preoperative weight reduction and minimisation of peri- and postoperative complications.
However, the evidence regarding their influence on postoperative outcomes is inconsistent. Retrospective studies suggest that rapid weight loss immediately prior to orthopaedic surgery may increase the risk of complications, including septic shock and revision surgery. Meta-analyses, on the other hand, indicate potential protective effects in surgical outcomes with prior long-term weight reduction.
There are currently no sufficiently qualitative studies on the safety and efficacy of these new drugs in the orthopaedic surgery sector. An individualised and multidisciplinary approach, therefore, remains relevant in order to achieve an optimal surgical outcome for the individual patient.
肥胖患病率的不断上升给骨科手术带来了重大且日益严峻的挑战。对于病态肥胖患者而言尤其如此，他们术后并发症的风险显著增加。新型基于肠促胰素的疗法（如司美格鲁肽和替尔泊肽），即这些所谓的“减肥针”，为术前减重以及减少围手术期和术后并发症提供了有前景的潜力。
然而，关于它们对术后结果影响的证据并不一致。回顾性研究表明，骨科手术前立即快速减重可能会增加并发症风险，包括感染性休克和翻修手术。另一方面，荟萃分析表明，长期术前减重对手术结果有潜在保护作用。
目前在骨科手术领域，尚无关于这些新药安全性和有效性的充分定性研究。因此，为了使个体患者获得最佳手术结果，个体化和多学科方法仍然至关重要。
