Glucagon-Like Peptide Receptor-1 Agonists Used for Medically-Supervised Weight Loss in Patients With Hip and Knee Osteoarthritis: Critical Considerations for the Arthroplasty Surgeon

Nathanael D. Heckmann, MD; Ryan Palmer, BS; Cory K. Mayfield, MD; Gligor Gucev, MD; Jay R. Lieberman, MD; Kurt Hong, MD, PhD

Arthroplasty Today (Jun 2024)

Glucagon-Like Peptide Receptor-1 Agonists Used for Medically-Supervised Weight Loss in Patients With Hip and Knee Osteoarthritis: Critical Considerations for the Arthroplasty Surgeon

Nathanael D. Heckmann, MD,
Ryan Palmer, BS,
Cory K. Mayfield, MD,
Gligor Gucev, MD,
Jay R. Lieberman, MD,
Kurt Hong, MD, PhD

Affiliations

Nathanael D. Heckmann, MD: Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA; Corresponding author. Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, 1520 San Pablo Street, Ste 2000, Los Angeles, CA 90033, USA. Tel.: +1 323 704 6363.
Ryan Palmer, BS: Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Cory K. Mayfield, MD: Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Gligor Gucev, MD: Department of Anesthesiology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Jay R. Lieberman, MD: Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Kurt Hong, MD, PhD: Center for Clinical Nutrition, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA

Journal volume & issue: Vol. 27
p. 101327

Abstract

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Patients with morbid obesity and concomitant hip or knee osteoarthritis represent a challenging patient demographic to treat as these patients often present earlier in life, have more severe symptoms, and have worse surgical outcomes following total hip and total knee arthroplasty. Previously, bariatric and metabolic surgeries represented one of the few weight loss interventions that morbidly obese patients could undergo prior to total joint arthroplasty. However, data regarding the reduction in complications with preoperative bariatric surgery remain mixed. Glucagon-like peptide receptor-1 (GLP-1) agonists have emerged as an effective treatment option for obesity in patients with and without diabetes mellitus. Furthermore, recent data suggest these medications may serve as potential anti-inflammatory and disease-modifying agents for numerous chronic conditions, including osteoarthritis. This review will discuss the GLP-1 agonists and GLP-1/glucose-dependent insulinotropic polypeptide dual agonists currently available, along with GLP-1/glucose-dependent insulinotropic polypeptide/glucagon triple agonists presently being developed to address the obesity epidemic. Furthermore, this review will address the potential problem of GLP-1-related delayed gastric emptying and its impact on the timing of elective total joint arthroplasty. The review aims to provide arthroplasty surgeons with a primer for implementing this class of medication in their current and future practice, including perioperative instructions and perioperative safety considerations when treating patients taking these medications.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

About the journal

Abstract

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