OBJECTIVES: The use of glucagon-like peptide-1 (GLP-1) receptor agonists is increasingly common among orthopaedic patients, often prescribed for type 2 diabetes mellitus and obesity, which are frequent comorbidities. Recent studies have explored the effects of GLP-1's on postoperative outcomes in orthopaedic procedures. This study evaluates the impact of GLP-1 on re-operation risk following rotator cuff repair (RCR).
METHODS: A retrospective cohort analysis of patients aged 18 and older from 2014 to 2024 was conducted using the TriNetX US collaborative network. Patients with documented RCR and no prior GLP-1 use were included in the control group. Those taking semaglutide, dulaglutide, or liraglutide for at least 3 months before RCR comprised the GLP-1 group. After comparing baseline characteristics, cohorts were matched based on selected covariates. Outcomes were compared using risk ratios (RR) with 95 % confidence intervals (CI). A subgroup analysis by GLP-1 indication (type 2 diabetes or weight loss) was performed.
RESULTS: Propensity score matching yielded well-balanced cohorts of 5306 patients. Subgroup analysis included 781 patients per group. At 3, 6, and 12 months post-RCR, the control group showed no difference in reoperation risk. In a sub-analysis of the GLP-1 group, those receiving it for diabetes, compared to obesity, showed an increased risk of adhesive capsulitis at 3 months (RR = 2.20, 95 % CI [1.05-4.62], P = 0.0321).
CONCLUSION: The use of GLP-1 was not associated with a higher reoperation risk after RCR, suggesting that these medications can safely be taken leading up to RCR. However, increased short-term risks in diabetes patients highlight the need for individualized care and further study of GLP-1 effects on orthopaedic outcomes.