{
    "abstract": "Weight optimization methods in morbidly obese patients with a body mass index (BMI) of \u226540 kg/m 2 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 2 undergoing primary TKA.\nUsing 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 2 . Outcomes including infection, complications, revision, and readmission were compared between the matched cohorts.\nThere 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 2 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 2 ), patients who had a BMI of \u226540 kg/m 2 and were taking a GLP-1 RA did not have increased rates of infection or 90-day or 2-year complications (p > 0.05).\nGLP-1 RA administration for at least 90 days prior to and after primary TKA in patients with a BMI of \u226540 kg/m 2 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 2 undergoing TKA. Randomized clinical trials are needed to define the true effect of these agents on clinical outcomes following TKA.\nTherapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.",
    "authors": [
        {
            "affiliation": "Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.",
            "firstname": "Billy I",
            "initials": "BI",
            "lastname": "Kim"
        },
        {
            "affiliation": null,
            "firstname": "Scott M",
            "initials": "SM",
            "lastname": "LaValva"
        },
        {
            "affiliation": null,
            "firstname": "Michael L",
            "initials": "ML",
            "lastname": "Parks"
        },
        {
            "affiliation": null,
            "firstname": "Peter K",
            "initials": "PK",
            "lastname": "Sculco"
        },
        {
            "affiliation": null,
            "firstname": "Alejandro G",
            "initials": "AG",
            "lastname": "Della Valle"
        },
        {
            "affiliation": null,
            "firstname": "Gwo-Chin",
            "initials": "GC",
            "lastname": "Lee"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2024 by The Journal of Bone and Joint Surgery, Incorporated.",
    "doi": "10.2106/JBJS.24.00468",
    "journal": "The Journal of bone and joint surgery. American volume",
    "keywords": [],
    "methods": null,
    "publication_date": "2024-12-24",
    "pubmed_id": "39719003",
    "results": "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 2 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 2 ), patients who had a BMI of \u226540 kg/m 2 and were taking a GLP-1 RA did not have increased rates of infection or 90-day or 2-year complications (p > 0.05).",
    "title": "Glucagon-Like Peptide-1 Receptor Agonists Decrease Medical and Surgical Complications in Morbidly Obese Patients Undergoing Primary TKA.",
    "xml": "<Element 'PubmedArticle' at 0x78850647aed0>"
}