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Table 2
Clinical evidence of GLP-1RA relevant to orthopaedic outcomes.
| Study | Orthopaedic/surgical contexts | Key findings | Comments |
|---|---|---|---|
| Driessen et al. [2] | Population-based T2DM cohorts | No correlation between GLP-1RA use and fracture incidence | Fracture risk neutral overall |
| Wiener et al. [5] | Spine surgery (15,000 patients) | Improved rehab engagement, fewer recovery barriers | Demonstrates holistic recovery benefit |
| Anastasilakis et al. [8] | RCTs & cohorts in T2DM & PwO | Mixed BMD results; LS stable, TH ↓; BTMs ↑; fracture risk neutral; possible hip-specific benefit | Exercise mitigates BMD loss; weight loss confounder |
| Mabilleau [16] | Bone quality & fracture healing in T2DM | GLP-1RA stabilises glucose/inflammation → better healing | Mechanistic support for metabolic-bone axis |
| Magaldi et al. [21] | Total hip arthroplasty | Reduced postoperative complications, GI side-effects noted | Feasible in arthroplasty setting |
| Kaneko et al. [30] | Perioperative glycemic control in ERAS | Liraglutide improved metabolic stability peri-op | Associated with reduced risk of cardiovascular events and infections, better weight management and better recovery |
T2DM: type 2 diabetes mellitus; RCTs: randomized controlled trials; PwO: people living with obesity; ERAS: enhanced recovery after surgery; BMD: bone mineral density; LS: lumbar spine; TH: total hip; BTM: bone turnover markers.
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