GLP-1 Receptor Agonists and Total Hip Arthroplasty Outcomes: A Systematic Review
Rolanda Willacy, MD*, Desiree Ojo, DO, Jaliah Allen, Gabrielle Baker, Je’Marcus McDaniel, Bobbi Cooke and Marvin Dingle, MD
ABSTRACT
Introduction: The rising prevalence of obesity has contributed to an increased burden of orthopedic complications, including higher risks of infection, thromboembolism, and revision surgery following total hip arthroplasty (THA). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), initially developed for type 2 diabetes, have recently been evaluated for their impact on THA outcomes. Emerging evidence suggests that GLP-1 RAs may reduce postoperative complications such as prosthetic joint infection, readmissions, and revisions, particularly among patients with obesity and diabetes. However, findings remain inconsistent, as some studies report significant benefits and others show no difference. This systematic review synthesizes the current evidence, highlights areas of consensus and variability, and identifies directions for future research relevant to orthopedic practice.
Methods: A systematic review of PubMed and Google Scholar was conducted August 2025, for primary articles published between August 2015 to 2025 using the terms: GLP-1 receptor, Glucagon-Like Peptide 1, agonist, semaglutide, liraglutide, dulaglutide, total hip arthroplasty, hip replacement, complications, infection, revision, outcomes, complications, infection, revision. Boolean terms AND and OR were used to refine results. Inclusion criteria: full-text English-language human studies from the United States involving adults (≥ 18 years old) and primary studies. Exclusion criteria included non-English studies, studies outside the time window or outside the United States, secondary literature, insufficient information, and studies lacking specification of THA, GLP-1 RA use, or postoperative outcomes.
Results: Thirty-nine records were identified (see Figure 1). After removing duplicates and automated exclusions, 23 studies were screened and 12 were excluded for reasons including lack of GLP-1 RA focus , not specific to THA, or omitting surgical outcomes. Eleven studies met the inclusion criteria. Across these studies, perioperative GLP-1 RA use in THA was consistently safe. Several analyses demonstrated no increase in infection, revision, or periprosthetic fracture rates, while others showed reduced rates of readmission, prosthetic joint infection, or acute blood loss anemia.
Conclusion: Current literature suggests GLP-1 RAs are safe in the perioperative period of THA and may improve outcomes postoperatively. Further investigation is warranted to clarify benefits in high-risk populations such as patients with morbid obesity and both diabetic and nondiabetic cohorts.
