{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:55:27Z","timestamp":1791474927821,"version":"4.3.4"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2,19]]},"abstract":"\n Background:<\/jats:title>\n \n Weight optimization methods in morbidly obese patients with a body mass index (BMI) of \u226540 kg\/m\n 2<\/jats:sup>\n undergoing total knee arthroplasty (TKA) have shown mixed results. The purpose of this study was to evaluate the effect of perioperative use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with a BMI of \u226540 kg\/m\n 2<\/jats:sup>\n undergoing primary TKA.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Using an administrative claims database, patients with morbid obesity undergoing primary TKA were stratified into GLP-1 RA use for 3 months before and after the surgical procedure (treatment group) and GLP-1 RA non-use (control group), and were matched on the basis of patient age, gender, diagnosis of type-2 diabetes mellitus, and Charlson Comorbidity Index (CCI). In addition, these groups were compared with a contemporaneous cohort of patients undergoing TKA with a BMI of 35.0 to 39.9 kg\/m\n 2<\/jats:sup>\n . Outcomes including infection, complications, revision, and readmission were compared between the matched cohorts.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n There were significant decreases in the rates of 90-day periprosthetic joint infection (PJI) (1.0% compared with 1.8%; p = 0.037), any medical complications (10.6% compared with 12.7%; p = 0.033), pulmonary embolism (<0.4% compared with 0.6%; p = 0.050), and readmissions (5.3% compared with 8.9%; p < 0.001) in patients with a BMI of \u226540 kg\/m\n 2<\/jats:sup>\n who were taking GLP-1 RA versus the control group who were not. There were no differences in the 2-year rates of surgical complications (p > 0.05) between these groups. Compared with obese patients (BMI of 35.0 to 39.9 kg\/m\n 2<\/jats:sup>\n ), patients who had a BMI of \u226540 kg\/m\n 2<\/jats:sup>\n and were taking a GLP-1 RA did not have increased rates of infection or 90-day or 2-year complications (p > 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n GLP-1 RA administration for at least 90 days prior to and after primary TKA in patients with a BMI of \u226540 kg\/m\n 2<\/jats:sup>\n was associated with reductions in the risks of 90-day PJI, any medical complications, and readmission. Additionally, the reduced complication rate that was achieved was similar to that of obese patients with a BMI of 35.0 to 39.9 kg\/m\n 2<\/jats:sup>\n undergoing TKA. Randomized clinical trials are needed to define the true effect of these agents on clinical outcomes following TKA.\n <\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n \n Therapeutic\n Level III<\/jats:underline>\n . See Instructions for Authors for a complete description of levels of evidence.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.24.00468","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T14:00:35Z","timestamp":1735048835000},"page":"348-355","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":64,"title":["Glucagon-Like Peptide-1 Receptor Agonists Decrease Medical and Surgical Complications in Morbidly Obese Patients Undergoing Primary TKA"],"prefix":"10.2106","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1519-6566","authenticated-orcid":false,"given":"Billy I.","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2276-7213","authenticated-orcid":false,"given":"Scott M.","family":"LaValva","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3568-6212","authenticated-orcid":false,"given":"Michael L.","family":"Parks","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter K.","family":"Sculco","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2177-5919","authenticated-orcid":false,"given":"Alejandro G.","family":"Della Valle","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4122-7976","authenticated-orcid":false,"given":"Gwo-Chin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"issue":"5","key":"bib1-20250219","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1016\/j.surg.2023.02.001","article-title":"The association between obesity and postoperative outcomes in a broad surgical population: a 7-year American College of Surgeons National Surgical Quality Improvement analysis","volume":"173","author":"Madsen","year":"2023","journal-title":"Surgery."},{"issue":"1","key":"bib2-20250219","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s42836-021-00102-7","article-title":"Obesity, preoperative weight loss, and telemedicine before total joint arthroplasty: a review","volume":"4","author":"Seward","year":"2022","journal-title":"Arthroplasty."},{"issue":"4","key":"bib3-20250219","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s00402-019-03127-5","article-title":"The outcomes of total knee arthroplasty in morbidly obese patients: a systematic review of the literature","volume":"139","author":"Boyce","year":"2019","journal-title":"Arch Orthop Trauma Surg."},{"issue":"2","key":"bib4-20250219","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.jor.2018.02.009","article-title":"Surgical site infection in overweight and obese total knee arthroplasty patients","volume":"15","author":"Wilson","year":"2018","journal-title":"J Orthop."},{"issue":"5","key":"bib5-20250219","first-page":"714","article-title":"Knee Surgeons Evidence Based Committee. 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