Semaglutide-based medications, including Ozempic and Wegovy, have garnered significant attention for their efficacy in supporting weight loss. Ozempic is usually prescribed for the management of Type 2 diabetes, has emerged as a widely accepted option for weight control. Meanwhile, Wegovy, approved in 2021 for long-term weight management, incorporates semaglutide as its active ingredient.
The American Academy of Orthopaedic Surgeons (AAOS) emphasizes the heightened risk of complications following joint replacement surgeries among individuals with obesity and diabetes, including challenges in wound healing and susceptibility to infections. With the increasing use of semaglutide for diabetes and weight management, understanding its potential impact on postoperative outcomes becomes imperative.
Studies presented at the AAOS 2024 Annual Meeting delved into semaglutide’s influence on the outcomes of total hip arthroplasty (THA). One such study, leveraging the comprehensive TriNetX database, compared postoperative complications among obese THA patients using semaglutide with those who were not. Led by David Momtaz, MPH, and Daniel Pereira, MD, the analysis revealed comparable complication rates between the cohorts, encompassing revision surgeries, infections, mortality, and other adverse events, indicating that semaglutide use did not significantly alter the risk profile of THA patients.
Another investigation, spearheaded by Dr. Matthew Magruder of Maimonides Medical Center, focused on diabetic patients undergoing THA while on semaglutide. Their retrospective analysis unveiled encouraging findings, showcasing lower readmission rates and fewer prosthetic joint infections among patients using semaglutide. Importantly, this was achieved without a notable increase in other postoperative complications or associated costs.
Preliminary data unveiled at the AAOS meeting hinted at potential benefits of semaglutide in the context of hip replacement surgery. One study assessing the impact of Ozempic revealed a significant reduction (44%) in joint infections and a lower readmission rate (32%) among patients prescribed the medication. Furthermore, another investigation demonstrated that the use of Wegovy did not elevate the risk of postoperative complications, including infections, reoperations, or mortality, in THA patients.
Despite these promising insights, it’s essential to note certain limitations within these studies. Specifically, there is a lack of data regarding the duration of semaglutide use before surgery, and neither study received commercial funding. Consequently, while these findings offer optimism, they do not definitively support the routine initiation of GLP-1 agonists like semaglutide before hip replacement surgery. Dr. Magruder underscores the necessity for high-quality randomized controlled trials to establish clear recommendations regarding the use of such medications in this surgical context.
Semaglutide presents a promising avenue for improving outcomes in patients undergoing hip replacement surgery, particularly in mitigating complications such as joint infections and readmissions. However, further research, including prospective trials, is warranted to solidify its role in preoperative management strategies. The evolving landscape of semaglutide’s potential benefits in the realm of joint replacement surgery calls for continued investigation and scrutiny to optimize patient outcomes.
