Glucagon-Like Peptide-1 Receptor Agonist Use in Obese Patients Is Associated With Decreased Risk of Revision and Retears After Arthroscopic Rotator Cuff Repair.

PURPOSE: To evaluate the impact of preoperative glucagon-like peptide-1 receptor agonist (GLP-1 RA) use on medical complications, emergency department use, and orthopaedic complications in obese patients undergoing arthroscopic rotator cuff repair.

METHODS: Obese patients (defined by relevant ICD-10 codes and confirmed by body mass index measurements) undergoing primary arthroscopic rotator cuff repair before June 2023 with at least 2-year follow-up were found in the TriNetX database and stratified according to GLP-1 RA use before surgery. Patients prescribed GLP-1 RAs were propensity-matched 1:1 to non-GLP-1 RAs controls by age, sex, ethnicity, and comorbidities. Outcomes assessed included emergency department use at 30 and 90 days, medical complications assessed at 90 days, and orthopaedic complications (including revision, retear, and conversion to arthroplasty rates, defined by ICD-10 codes) assessed at 1 and 2 years postoperatively. Statistical analysis was performed using TriNetX's built-in statistical platform.

RESULTS: Following matching, both cohorts consisted of 1183 patients and had no baseline differences. At 90 days, there were no significant differences in medical complications, including acute kidney injury, pneumonia, venous thromboembolism, urinary tract infection, or cardiac events. At 1 and 2 years, GLP-1 RA use was associated with significantly lower revision rates after left-sided repairs (2.3% vs 7.2%, OR 0.3, P < .001; 4.0% vs 8.2%, OR 0.5, P = .010, respectively). In subgroup analyses, women undergoing left-sided repairs showed significantly lower retear rates at both 1 and 2 years (19.1% vs 30.9%, OR 0.5, P = .009; 20.2% vs 33.5%, OR 0.5, P = .004).

CONCLUSIONS: GLP-1 RAs appear to be generally safe for preoperative use in obese patients undergoing arthroscopic rotator cuff repair and were associated with decreased rates of revision and retear in certain subgroups.

LEVEL OF EVIDENCE: Level III, retrospective comparative case series.