{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:25:22Z","timestamp":1787300722755,"version":"build-2736575974"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"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 &amp; Ankle Specialist"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Glucagon-like peptide-1 (GLP-1) receptor agonists are widely used for the treatment of obesity and type 2 diabetes mellitus (T2DM), with established metabolic benefits. However, their influence on musculoskeletal outcomes, particularly in patients with ankle osteoarthritis (OA), remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study using the TriNetX Analytics Network to evaluate the association between GLP-1 therapy and surgical or nonsurgical interventions for ankle OA. Adults with obesity (body mass index [BMI] \u226530\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) or T2DM (ICD-10: E11) were identified between 2016 and 2020. Patients were stratified by GLP-1 use, defined as \u22652 prescriptions separated by \u22656 months for semaglutide, liraglutide, dulaglutide, exenatide, or lixisenatide. Outcomes included ankle joint injection (CPT: 20605, 20606), ankle arthroscopy\/debridement (CPT: 29891, 29898, 29897, 29895), and total ankle arthroplasty (TAA) or arthrodesis (CPT: 27700, 27702, 27870, 29899). Outcomes were analyzed beginning 6 months after index date. Hazard ratios (HRs) were estimated with 95% confidence intervals (CIs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, 3089 obese and 8117 diabetic patients were included in each comparison group. In the obese cohort, GLP-1 users had a lower risk of ankle joint injection (HR\u2009=\u20090.8, 95% CI\u2009=\u20090.6-0.9) and TAA (HR\u2009=\u20090.5, 95% CI\u2009=\u20090.3-0.9), while risk of arthroscopy was not significantly different. In the diabetic cohort, GLP-1 use was associated with increased risk of arthroscopy (HR\u2009=\u20091.9, 95% CI\u2009=\u20091.2-3.2) but not joint injection or TAA. Over 5 years, GLP-1 users achieved greater reductions in BMI compared with non-users (obese cohort: \u22122.7 vs \u22121.6\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; diabetic cohort: \u22122.1 vs \u22121.7\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; both P\u2009&lt;\u2009.01). HbA1c improved significantly in both diabetic groups, with slightly greater reduction in non-users (\u22126.0% vs \u22125.5%, P\u2009&lt;\u2009.01)\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Obese GLP-1 users demonstrated lower rates of invasive ankle procedures, while diabetic GLP-1 users experienced higher arthroscopy utilization. These findings suggest that metabolic improvements may not uniformly translate to musculoskeletal benefit, warranting further investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">III<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19386400261471652","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:31:49Z","timestamp":1787034709000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of GLP-1 Receptor Agonists on Surgical and Nonsurgical Treatment of Ankle Osteoarthritis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4002-5807","authenticated-orcid":false,"given":"Ysa","family":"Le","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Thai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Siragusa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilia","family":"Elsabbagh","sequence":"additional","affiliation":[{"name":"Arizona State University, Tempe, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indeevar","family":"Beeram","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amiethab","family":"Aiyer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10194489"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2013.08.003"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/24730114221112955"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-011-1472-7"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-51.5.08"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0996"},{"key":"e_1_3_3_8_2","unstructured":"Ankle injuries and fractures in the obese patient\u2014ClinicalKey. Accessed October 8 2025. https:\/\/www-clinicalkey-com.proxy.libraries.rutgers.edu\/#!\/content\/journal\/1-s2.0-S0030589810000660?scrollTo=%23bib8"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2014.01.004"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2017.01.016"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2022.02.001"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2015.03.031"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/phar.70005"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/1938640012448057"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2012.01.005"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0801655"},{"key":"e_1_3_3_17_2","unstructured":"Hermena S Bergman R Dalgleish S. Ankle arthroscopy. In. StatPearls. StatPearls Publishing; 2025. 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