{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T11:38:35Z","timestamp":1792582715944,"version":"4.5.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, whereas semaglutide is selective for the GLP-1 receptor. We compared post-operative outcomes after primary total knee or hip arthroplasty (TKA\/THA) between patients prescribed tirzepatide and those prescribed semaglutide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was performed using the TriNetX US Collaborative Network. Adults undergoing primary TKA or THA with at least two coded prescription fills for tirzepatide or semaglutide within six months of surgery were identified, and patients taking both agents were excluded. Cohorts were propensity score matched 1:1 (2,858 per group, all standardized differences below 0.05). Odds ratios (OR) with 95% confidence intervals (CI) were calculated at 90 days, 1 year, and 2 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 669,698 patients who underwent primary TKA or THA, 8,797 (1.3%) had\u2009\u2265\u20092 tirzepatide or semaglutide prescriptions. At 90 days and 1 year, no surgical, medical, or implant-related outcome differed significantly. At 2 years, tirzepatide exposure was associated with lower odds of mechanical complications (OR 0.64, 95% CI 0.42 to 0.96) and periprosthetic joint infection (PJI) (OR 0.64, 95% CI 0.41 to 0.99;\n                      <jats:italic>P<\/jats:italic>\n                      = .048). Reoperation did not differ significantly (OR 0.68, 95% CI 0.43 to 1.08).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tirzepatide and semaglutide prescriptions were associated with similar 90\u00a0day and 1 year outcomes, while tirzepatide was associated with lower mechanical complications and PJI at 2-years. These preliminary associations warrant further investigation in larger cohorts to improve precision and clarify their clinical relevance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00590-026-05000-9","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T10:42:36Z","timestamp":1792579356000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual GIP\/GLP-1 receptor agonist versus selective GLP-1 receptor agonist in patients undergoing primary total knee or hip arthroplasty"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8012-5594","authenticated-orcid":false,"given":"Spencer C.","family":"Davis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlok V.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Fletcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"McLaughlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E.","family":"Deren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas S.","family":"Piuzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"5000_CR1","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.1016\/S0140-6736(18)31777-X","volume":"392","author":"RJ Ferguson","year":"2018","unstructured":"Ferguson RJ, Palmer AJR, Taylor A, Porter ML, Malchau H, Glyn-Jones S (2018) Hip replacement. Lancet 392:1662\u20131671. https:\/\/doi.org\/10.1016\/S0140-6736(18)31777-X","journal-title":"Lancet"},{"key":"5000_CR2","doi-asserted-by":"publisher","first-page":"1672","DOI":"10.1016\/S0140-6736(18)32344-4","volume":"392","author":"AJ Price","year":"2018","unstructured":"Price AJ, Alvand A, Troelsen A, Katz JN, Hooper G, Gray A et al (2018) Knee replacement. Lancet 392:1672\u20131682. https:\/\/doi.org\/10.1016\/S0140-6736(18)32344-4","journal-title":"Lancet"},{"key":"5000_CR3","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.2106\/JBJS.17.01617","volume":"100","author":"M Sloan","year":"2018","unstructured":"Sloan M, Premkumar A, Sheth NP (2018) Projected volume of primary total joint arthroplasty in the U.S., 2014 to 2030. J Bone Joint Surg Am 100:1455\u20131460. https:\/\/doi.org\/10.2106\/JBJS.17.01617","journal-title":"J Bone Joint Surg Am"},{"key":"5000_CR4","doi-asserted-by":"publisher","first-page":"274","DOI":"10.2471\/BLT.25.294300","volume":"104","author":"PG Delaney","year":"2026","unstructured":"Delaney PG, Piuzzi NS (2026) A call for inclusion of arthroplasty as essential surgery. Bull World Health Organ 104:274\u2013281. https:\/\/doi.org\/10.2471\/BLT.25.294300","journal-title":"Bull World Health Organ"},{"key":"5000_CR5","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.2106\/JBJS.N.01141","volume":"97","author":"H Maradit Kremers","year":"2015","unstructured":"Maradit Kremers H, Larson DR, Crowson CS, Kremers WK, Washington RE, Steiner CA et al (2015) Prevalence of total hip and knee replacement in the United States. J Bone Joint Surg Am 97:1386\u20131397. https:\/\/doi.org\/10.2106\/JBJS.N.01141","journal-title":"J Bone Joint Surg Am"},{"key":"5000_CR6","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.arth.2012.02.022","volume":"27","author":"SM Kurtz","year":"2012","unstructured":"Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J (2012) Economic burden of periprosthetic joint infection in the United States. J Arthroplasty 27:61\u201365e1. https:\/\/doi.org\/10.1016\/j.arth.2012.02.022","journal-title":"J Arthroplasty"},{"key":"5000_CR7","doi-asserted-by":"publisher","unstructured":"Carender CN, Fruth KM, Lewallen DG, Berry DJ, Abdel MP, Bedard NA (2024) Obesity and primary total hip arthroplasty: the absolute versus relative risk of periprosthetic joint infection at 15 years. J Arthroplasty 39. https:\/\/doi.org\/10.1016\/j.arth.2024.03.033. S436-S443.e1","DOI":"10.1016\/j.arth.2024.03.033"},{"key":"5000_CR8","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1056\/NEJMoa2032183","volume":"384","author":"JPH Wilding","year":"2021","unstructured":"Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I et al (2021) Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med 384:989\u20131002. https:\/\/doi.org\/10.1056\/NEJMoa2032183","journal-title":"N Engl J Med"},{"key":"5000_CR9","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","volume":"375","author":"SP Marso","year":"2016","unstructured":"Marso SP, Bain SC, Consoli A, Eliaschewitz FG, J\u00f3dar E, Leiter LA et al (2016) Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 375:1834\u20131844. https:\/\/doi.org\/10.1056\/NEJMoa1607141","journal-title":"N Engl J Med"},{"key":"5000_CR10","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.125.046302","author":"MM Hammond","year":"2026","unstructured":"Hammond MM, Krishnan V, Petito LC, Kazi DS, Khan SS, Huang X (2026) Trends in usage and payments for glucagon-like peptide-1 receptor agonists in the United States, 2017 to 2022: a nationally representative repeated cross-sectional study. J Am Heart Assoc. https:\/\/doi.org\/10.1161\/JAHA.125.046302","journal-title":"J Am Heart Assoc"},{"key":"5000_CR11","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s42836-026-00375-w","volume":"8","author":"O Abdelaziz","year":"2026","unstructured":"Abdelaziz O, Zayed ZG, Khalafallah MA, Hanafy MA, Hadhoud AM, Elmenawi KA (2026) Glucagon-like peptide-1 receptor agonists in total joint arthroplasty: a comprehensive systematic review of what orthopaedic surgeons should know. Arthroplasty 8:23. https:\/\/doi.org\/10.1186\/s42836-026-00375-w","journal-title":"Arthroplasty"},{"key":"5000_CR12","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1302\/0301-620X.102B6.BJJ-2019-1644.R1","volume":"102\u2013B","author":"N Arnold","year":"2020","unstructured":"Arnold N, Anis H, Barsoum WK, Bloomfield MR, Brooks PJ, Higuera CA et al (2020) Preoperative cut-off values for body mass index deny patients clinically significant improvements in patient-reported outcomes after total hip arthroplasty. Bone Joint J 102\u2013B:683\u2013692. https:\/\/doi.org\/10.1302\/0301-620X.102B6.BJJ-2019-1644.R1","journal-title":"Bone Joint J"},{"key":"5000_CR13","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1056\/NEJMoa2403664","volume":"391","author":"H Bliddal","year":"2024","unstructured":"Bliddal H, Bays H, Czernichow S, Udd\u00e9n Hemmingsson J, Hjelmes\u00e6th J, Hoffmann Morville T et al (2024) Once-weekly semaglutide in persons with obesity and knee osteoarthritis. N Engl J Med 391:1573\u20131583. https:\/\/doi.org\/10.1056\/NEJMoa2403664","journal-title":"N Engl J Med"},{"key":"5000_CR14","doi-asserted-by":"publisher","first-page":"232596712412971","DOI":"10.1177\/23259671241297157","volume":"13","author":"JR Porto","year":"2025","unstructured":"Porto JR, Lavu MS, Hecht CJ, Kaelber DC, Sculco PK, Heckmann ND et al (2025) The impact of contemporary glucagon-like peptide-1 receptor agonists on the onset, severity, and conversion to arthroplasty in hip and knee osteoarthritis. Orthop J Sports Med 13:23259671241297157. https:\/\/doi.org\/10.1177\/23259671241297157","journal-title":"Orthop J Sports Med"},{"key":"5000_CR15","doi-asserted-by":"publisher","first-page":"102255362513919","DOI":"10.1177\/10225536251391959","volume":"33","author":"Y Mashayekhi","year":"2025","unstructured":"Mashayekhi Y, Asgari AM, Pahlevan-Fallahy MT, Karimi MA, Jalali R, Shaker F (2025) Impact of glucagon-like peptide-1 receptor agonists on postoperative complications after total joint arthroplasty: a systematic review and meta-analysis. J Orthop Surg (Hong Kong) 33:10225536251391959. https:\/\/doi.org\/10.1177\/10225536251391959","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"5000_CR16","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1016\/j.arth.2024.10.099","volume":"40","author":"KY Heo","year":"2025","unstructured":"Heo KY, Goel RK, Woltemath A, Fuqua A, Hrudka BT, Syed O et al (2025) Glucagon-like peptide-1 receptor agonist use is not associated with increased complications after total hip arthroplasty in patients who have type 2 diabetes. J Arthroplasty 40:1413\u20131418e1. https:\/\/doi.org\/10.1016\/j.arth.2024.10.099","journal-title":"J Arthroplasty"},{"key":"5000_CR17","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1056\/NEJMoa2107519","volume":"385","author":"JP Fr\u00edas","year":"2021","unstructured":"Fr\u00edas JP, Davies MJ, Rosenstock J, P\u00e9rez Manghi FC, Fern\u00e1ndez Land\u00f3 L, Bergman BK et al (2021) Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes. N Engl J Med 385:503\u2013515. https:\/\/doi.org\/10.1056\/NEJMoa2107519","journal-title":"N Engl J Med"},{"key":"5000_CR18","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1016\/j.cmet.2018.03.001","volume":"27","author":"DJ Drucker","year":"2018","unstructured":"Drucker DJ (2018) Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metab 27:740\u2013756. https:\/\/doi.org\/10.1016\/j.cmet.2018.03.001","journal-title":"Cell Metab"},{"key":"5000_CR19","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1056\/NEJMoa2416394","volume":"393","author":"LJ Aronne","year":"2025","unstructured":"Aronne LJ, Horn DB, le Roux CW, Ho W, Falcon BL, Gomez Valderas E et al (2025) Tirzepatide as compared with semaglutide for the treatment of obesity. N Engl J Med 393:26\u201336. https:\/\/doi.org\/10.1056\/NEJMoa2416394","journal-title":"N Engl J Med"},{"key":"5000_CR20","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/S2213-8587(22)00070-5","volume":"10","author":"A Gastaldelli","year":"2022","unstructured":"Gastaldelli A, Cusi K, Fern\u00e1ndez Land\u00f3 L, Bray R, Brouwers B, Rodr\u00edguez \u00c1 (2022) Effect of tirzepatide versus insulin degludec on liver fat content and abdominal adipose tissue in people with type 2 diabetes (SURPASS-3 MRI): a substudy of the randomised, open-label, parallel-group, phase 3 SURPASS-3 trial. Lancet Diabetes Endocrinol 10:393\u2013406. https:\/\/doi.org\/10.1016\/S2213-8587(22)00070-5","journal-title":"Lancet Diabetes Endocrinol"},{"key":"5000_CR21","doi-asserted-by":"publisher","DOI":"10.1111\/dom.71106","author":"M Kanbay","year":"2026","unstructured":"Kanbay M, Shah E, AlShiab R, Ozbek L, Ay S, Rustamov A et al (2026) Effects of GLP-1 receptor agonists and dual GIP\/GLP-1 receptor agonists on inflammatory and metabolic biomarkers in type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab. https:\/\/doi.org\/10.1111\/dom.71106","journal-title":"Diabetes Obes Metab"},{"issue":"Suppl 1","key":"5000_CR22","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/dom.13129","volume":"20","author":"MA Nauck","year":"2018","unstructured":"Nauck MA, Meier JJ (2018) Incretin hormones: their role in health and disease. Diabetes Obes Metab 20(Suppl 1):5\u201321. https:\/\/doi.org\/10.1111\/dom.13129","journal-title":"Diabetes Obes Metab"},{"key":"5000_CR23","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","volume":"370","author":"E von Elm","year":"2007","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370:1453\u20131457. https:\/\/doi.org\/10.1016\/S0140-6736(07)61602-X","journal-title":"Lancet"},{"issue":"5","key":"5000_CR24","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1177\/11207000261450078","volume":"36","author":"B Benyamini","year":"2026","unstructured":"Benyamini B, Khan ST, Elmenawi KA et al (2026) 1-year patient-reported outcomes in patients with a documented GLP-1 agonist prescription history prior to total hip arthroplasty: a retrospective cohort study. Hip Int 36(5):791\u2013798. https:\/\/doi.org\/10.1177\/11207000261450078","journal-title":"Hip Int"}],"container-title":["European Journal of Orthopaedic Surgery &amp; Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-026-05000-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00590-026-05000-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-026-05000-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T10:42:37Z","timestamp":1792579357000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00590-026-05000-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5000"],"URL":"https:\/\/doi.org\/10.1007\/s00590-026-05000-9","relation":{},"ISSN":["1432-1068"],"issn-type":[{"value":"1432-1068","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]},"assertion":[{"value":"18 August 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study analysed de-identified, aggregated data from a federated research network and complied with all applicable laws of the country in which it was performed. Because the data contain no protected health information and no identifiable individual patients, the study did not constitute human subjects research, and institutional review board approval and individual patient consent were not required. The study was conducted in accordance with the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Spencer C. Davis, Shlok V. Patel and Shane Fletcher declare they have no competing interests. John P. McLaughlin has the following disclosures, none related to the present study: consultant for Zimmer Biomet, Smith and Nephew, and OrthAlign. Matthew E. Deren has the following disclosures, none related to the present study: paid speaker for Brasseler; stock options in ROM Technologies; governing board of The Journal of Knee Surgery. Nicolas S. Piuzzi has the following disclosures, none related to the present study: grants or contracts from Osteal Therapeutics, Peptilogics, RegenLab, Signature Orthopedics, Zimmer and Stryker; consulting fees from Zimmer, Pacira Pharmaceutical and Stryker; editorial board member or leadership role with JBJS, the American Association of Hip and Knee Surgeons and the Orthopaedic Research Society.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"417"}}