使用胰高血糖素样肽-1受体激动剂与肩袖修复后再手术风险增加无关

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-08-07 DOI:10.1016/j.jor.2025.08.016

Spencer T. Rasmussen , Asif M. Ilyas

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引用次数: 0

摘要

目的胰高血糖素样肽-1 （GLP-1）受体激动剂的使用在骨科患者中越来越普遍，通常用于2型糖尿病和肥胖，这是常见的合并症。最近的研究探讨了GLP-1对骨科手术后预后的影响。本研究评估GLP-1对肩袖修复（RCR）后再手术风险的影响。方法采用TriNetX美国协同网络对2014 - 2024年18岁及以上患者进行回顾性队列分析。有记录的RCR且既往未使用GLP-1的患者被纳入对照组。在RCR前服用西马鲁肽、杜拉鲁肽或利拉鲁肽至少3个月的患者组成GLP-1组。在比较基线特征后，根据选定的协变量对队列进行匹配。使用95%置信区间（CI）的风险比（RR）对结果进行比较。根据GLP-1适应症（2型糖尿病或体重减轻）进行亚组分析。结果倾向评分匹配产生5306例患者的均衡队列。亚组分析包括每组781例患者。rcr后3、6、12个月，对照组再手术风险无差异。在GLP-1组的亚分析中，与肥胖患者相比，接受GLP-1治疗的糖尿病患者在3个月时出现粘连性囊炎的风险增加（RR = 2.20, 95% CI [1.05-4.62], P = 0.0321）。结论GLP-1的使用与RCR后的再手术风险无相关性，提示在RCR发生前使用这些药物是安全的。然而，糖尿病患者短期风险的增加突出了个性化护理和进一步研究GLP-1对骨科预后影响的必要性。

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Glucagon-like Peptide-1 receptor agonist use is not associated with increased reoperation risk following rotator cuff repair

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.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.