{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T21:47:20Z","timestamp":1782078440269,"version":"3.54.5"},"reference-count":14,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot & Ankle Orthopaedics"],"published-print":{"date-parts":[[2026,4]]},"abstract":"\n Background:<\/jats:title>\n Ankle fractures occur at an estimated rate of 4.22\u2009per 10\u2009000\u2009person-years, occurring most frequently within the 21- to 30-year-old demographic. This retrospective cohort study used the TriNetX research network to evaluate the association between perioperative glucagon-like peptide-1 receptor agonist (GLP-1RA) use and postoperative complications following operative ankle fixation.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Adults were stratified by GLP-1RA exposure (n\u2009=\u20091199 for the 3-month cohort and n\u2009=\u20091397 for both the 6- and 12-month cohorts). These cohorts were balanced via 1:1 propensity score matching for age, race, sex, wound healing risk factors, and diabetes; matching was attempted for body mass index (BMI) and glycated hemoglobin (HbA\n 1c<\/jats:sub>\n ) but was not obtained. The 6 complications were assessed from 1\u2009day to 3\u2009months, 6\u2009months, and 1\u2009year postoperatively.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Results demonstrated that GLP-1RA therapy was significantly associated with increased risk of hardware failure, beginning at 3\u2009months (log rank test [LRT] \u03c7\n 2<\/jats:sup>\n \u2009=\u20093.838,\n P<\/jats:italic>\n \u2009=\u2009.050) and persisting through 12\u2009months (LRT \u03c7\n 2<\/jats:sup>\n \u2009=\u20095.527,\n P<\/jats:italic>\n \u2009=\u2009.019; risk difference [RD]\u2009=\u20090.017,\n P<\/jats:italic>\n \u2009=\u2009.018). Nonunion\/malunion rates in the GLP-1RA cohort were more common, with significance found at 6 months (RD\u2009=\u20090.010,\n P<\/jats:italic>\n \u2009=\u2009.047) and 12 months postoperatively (RD\u2009=\u20090.014,\n P<\/jats:italic>\n \u2009=\u2009.008). No association was observed with postoperative infection across any time point. Furthermore, a neutral significance was established for wound dehiscence and procedural complications. Although test statistics suggested potential variance, primary longitudinal measures did not demonstrate significant divergence between cohorts (12-month LRT\n P<\/jats:italic>\n \u2009=\u2009.131 and\n P<\/jats:italic>\n \u2009=\u2009.482, respectively).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n These findings suggest that perioperative GLP-1RA use is associated with increased rates of hardware failure and nonunion\/malunion, identifying a risk profile localized to osseous integrity. No association was found with postoperative infection, and a neutral significance was established for soft tissue complications. Interpreted in the context of residual imbalance in BMI and HbA\n 1c<\/jats:sub>\n , these findings are hypothesis-generating rather than confirmatory.\n <\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n Level III, retrospective cohort study.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/24730114261453350","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:31:43Z","timestamp":1781767903000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between GLP-1RAs and Postoperative Complications Following Operative Ankle Fracture Fixation: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5459-6467","authenticated-orcid":false,"given":"Shawn K.","family":"Monteiro","sequence":"first","affiliation":[{"name":"Department of Bioengineering, The University of Toledo, Toledo, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabeel A.","family":"Khatri","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, The University of Toledo, Toledo, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deen B.","family":"Sari","sequence":"additional","affiliation":[{"name":"College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Christopher","family":"Sanford","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, The University of Toledo, Toledo, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2019.09.016"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2022.01.010"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00789"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11914-015-0286-8"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbm4.10730"},{"key":"e_1_3_3_7_2","unstructured":"Hermena S Slane VH. Ankle Fracture. In: StatPearls [Internet]. StatPearls Publishing; 2025. Updated February 15 2025. Accessed April 7 2026. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542324\/"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2025.89778"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2025.101882"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102782"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2017.00098"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2025.112746"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-025-02468-5"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.70198"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2025.05.002"}],"container-title":["Foot & Ankle Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24730114261453350","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/24730114261453350","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24730114261453350","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T20:50:31Z","timestamp":1782075031000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/24730114261453350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/24730114261453350"],"URL":"https:\/\/doi.org\/10.1177\/24730114261453350","relation":{},"ISSN":["2473-0114","2473-0114"],"issn-type":[{"value":"2473-0114","type":"print"},{"value":"2473-0114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"article-number":"24730114261453350"}}