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Weight problems and diabetes build up the chance for headaches following joint surgical procedures like general hip alternative, however can semaglutide and linked medication lend a hand?

The query has large implications. Greater than 450,000 general hip arthroplasty (THA) procedures are carried out once a year in the USA, with the quantity anticipated to develop to 850,000 via 2030. Weight problems is the main reason why for the rise. Semaglutide and different glucagon-like peptide 1 (GLP-1) receptor agonists can result in dramatic and fast weight reduction, along with controlling diabetes, so researchers have questioned if the drugs would possibly support results in sufferers present process joint surgical treatment.

Two research introduced on the 2024 annual assembly of the American Academy of Orthopaedic Surgeons (AAOS) sought to respond to the query — however reached other conclusions.

One find out about of THA sufferers taking semaglutide discovered fewer 90-day readmissions for diabetes and less prosthetic joint infections on the 2-year mark. Every other discovered equivalent results at the want for revision surgical treatment, infections, and lots of different postsurgery metrics in individuals who took the GLP-1 receptor agonist and those that didn’t. Neither find out about had outdoor investment.

Learn about: Fewer Infections, Readmissions

For his or her find out about, Matthew Magruder, MD, a third-year orthopedic resident at Maimonides Clinical Middle’s Division of Orthopaedic Surgical operation and Rehabilitation in New York Town, and his colleagues used an administrative declare database (PearlDiver) to spot THA sufferers who underwent the surgical treatment between January 1, 2020, to October 31, 2021, when semaglutide was once authorized for the remedy of diabetes however no longer but for weight problems. The researchers discovered 9465 sufferers who had had a number one THA, of whom 1653 had won a prescription for semaglutide.

In general, 84.9% of the ones on semaglutide had weight problems, as did 85.2% of the ones no longer at the medicine.

Magruder’s crew checked out clinical headaches comparable to deep vein thrombosis, myocardial infarction, hypoglycemia, and pulmonary embolism inside 90 days of surgical treatment, implant-related headaches 2 years after the process, charges of readmission inside 90 days of the process, period of keep within the clinic, and prices of care.

They discovered that sufferers taking semaglutide have been much less more likely to be readmitted to the clinic inside 90 days of THA (6.2% vs 8.8%; P <.01) and skilled fewer joint infections (1.6% vs 2.9%; P <.01). No important variations have been discovered within the different results.

photo of Matthew Magruder, MD
Matthew Magruder, MD

Some of the doable issues involving the usage of GLP-1 receptor agonists in sufferers present process surgical treatment are their doable to purpose hypoglycemia and the possibility for aspiration throughout anesthesia. However the ones problems didn’t emerge within the research.

“We concluded that this was once initial proof that the use of semaglutide on the time of surgical treatment was once secure and doubtlessly efficient at lowering headaches,” stated Magruder, whose crew printed their findings in The Magazine of Arthroplasty.

Learn about: Semaglutide Has No Impact on Postop Headaches

In some other find out about introduced on the AAOS assembly, researchers discovered that charges of headaches after THA have been equivalent in sufferers with weight problems who took semaglutide and those that didn’t. That knowledge might be useful for clinicians who’ve been reluctant to accomplish THA procedures in sufferers who even have had bariatric surgical treatment, stated Daniel E. Pereira, MD, a resident at Washington College in St. Louis and the primary writer of the find out about.

A contemporary retrospective evaluate discovered that sufferers who had bariatric surgical treatment have worse implant survivorship and better charges of dislocation than do the ones with a naturally low or top frame mass index (BMI).

Pereira and his colleagues used a countrywide database, with deidentified affected person information, initially discovering 42,410 sufferers. After matching, they evaluated 616 in every cohort: those that took semaglutide and those that didn’t. The typical age was once 62.7 years; reasonable BMI was once 35.5.

Each teams had a equivalent possibility for a variety of headaches together with revision surgical treatment, an infection of the brand new joint and surgical website, opioid-related problems, pulmonary embolism, deep vein thrombosis, and mortality.

photo of David Momtaz, MPH

“We did not follow anything else important [between groups] on the subject of the headaches,” stated David Momtaz, MPH, a fourth-year clinical pupil on the College of Texas Well being Science Middle at San Antonio, who helped habits the analysis.

Pereira stated he was hoping the effects would finish the hesitation he observes, in part because of a loss of analysis, amongst some physicians about prescribing semaglutide sooner than THA in suitable sufferers. “Our initial proof suggests there is not any want to withhold THA in sufferers who effectively misplaced weight on semaglutide,” he stated.

Skilled Viewpoint: No longer Surprising

Peter Hanson, MD, an orthopedic surgeon and orthopedic clinical director at Sharp Grossmont Health center in L. a. Mesa, California, who makes a speciality of hip and knee alternative, stated he was once unsurprised via the findings.

The sufferers he has seen on GLP-1 receptor agonists shed weight, he stated, and a couple of even to the purpose of no longer wanting a alternative. A contemporary find out about discovered that each 1% lower in weight was once related to a 2% decreased possibility for knee alternative in the ones with knee osteoarthritis or in danger for it, and each 1% drop in weight was once related to a three% decreased possibility for THA.

“I all the time advise my obese affected person to lose no less than 30 kilos, although their BMI is lower than 40, like many in those research,” Hanson stated. If a affected person’s physician prescribes semaglutide or some other GLP-1 receptor agonist, “I’m very supportive, and we put off surgical treatment till the load loss is maximized,” he added.

Magruder, Pereira, Momtaz, and Hanson haven’t any disclosures.

Kathleen Doheny is a journalist in Los Angeles.

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