Research Indicates Weight Loss Medications Do Not Affect THA Outcomes

Ozempic and Wegovy, which both contain the active ingredient semaglutide, have received considerable attention in the media and on social platforms lately for their ability to help people lose weight. Ozempic, which is approved for people with Type 2 diabetes, has now become a widely accepted choice for weight loss, and Wegovy was approved in 2021 for long-term weight management.
 
According to the American Academy of Orthopaedic Surgeons (AAOS), obesity and diabetes increases a person’s risk of having a medical or surgical complication after joint replacement, such as wound healing problems and infection. As the use of semaglutide increases among patients for diabetes and/or weight management, it’s important to understand the ways in which it can impact postoperative outcomes of joint replacement surgery.

Two studies examined the use of semaglutide and its impact on outcomes of total hip arthroplasty (THA), finding that patients who take semaglutide at the time of THA experience similar postoperative outcomes to those who do not take the drug.
 
The effect of semaglutide (Wegovy) treatment on postoperative outcomes of THA in patients with obesity: A matched study
Using a large comprehensive national database (TriNetX), researchers (co-led by David Momtaz, MPH, a fourth-year medical student at Long School of Medicine – UT Health San Antonio, and Daniel Pereira, M.D., orthopedic surgery resident at Washington University Barnes-Jewish Hospital) compared postoperative complications among obese patients who used semaglutide and underwent THA to patients without prior use of the medication who underwent the same procedure. A total of 616 patients in each cohort were analyzed. The average patient age was 62.7 years, 55% of patients were female and the average BMI was 35.5, which is considered to be obese.
 
The researchers found that postoperative complications after THA are similar between obese patients using semaglutide compared to those who did not. Both cohorts experienced a similar risk of hip arthroplasty revision, prosthesis infection, opioid-related disorders, surgical site infections, mortality, respiratory failure, pulmonary embolism, deep vein thrombosis, postoperative dehydration, cardiovascular comorbidities, shock, and prosthesis dislocations.
 
Semaglutide use prior to THA results in fewer postoperative prosthetic joint infections and readmissions
Researchers (led by Matthew Magruder, a third-year resident at Maimonides Health in Brooklyn, N.Y.) sought to evaluate whether diabetic patients who are taking semaglutide at the time of THA demonstrate: fewer medical complications; fewer implant related complications; fewer readmissions; and less costs. They conducted a retrospective query from Jan. 1, 2010, to Oct. 31, 2021, using the administrative claim database (PearlDiver). The findings note that diabetic patients who were taking semaglutide at time of THA:

• Did not demonstrate statistically significant higher rates of complications compared with controls.
• Had lower rates of readmission within 90 days of surgery and lower rates of prosthetic joint infection.
• There was no difference between groups for any other implant related complication and no difference between cohorts for lengths of stay, same-day surgical costs or 90-day episode of care costs. 

With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. The AAOS advances musculoskeletal health by providing comprehensive education to help orthopedic surgeons and allied health professionals best treat patients. The AAOS is the source for information on bone and joint conditions, treatments and related musculoskeletal healthcare issues; and it leads the healthcare discussion on advancing quality.