Results show increased long-term risk for osteoporosis, gout and osteomalacia in one study; improved postoperative outcomes for common orthopaedic procedures in another
NEW ORLEANS, March 2, 2026 /PRNewswire/ — The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including semaglutide, has expanded rapidly among patients with obesity and Type 2 diabetes due to the proven benefits in glycemic control, weight loss and cardiometabolic risk reduction. New research presented at the 2026 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) offers a closer look at how these medications may affect musculoskeletal health. Specifically, GLP-1 RAs may be associated with improved short-term postoperative benefits, alongside possible long-term risks of osteoporosis, gout and osteomalacia compared with non-users. “We are just now reaching the precipice where five- and 10-year follow-up data are becoming available for patients taking GLP-1 medications,” said Muaaz Wajahahth, a fourth-year medical student at Michigan State University College of Human Medicine and primary investigator of, “GLP Receptor Agonist Use is Associated with Increased Risk of Osteoporosis, Gout and Osteomalacia in Adults with Type 2 Diabetes and Obesity.” “Any medication that sees this rapid adoption warrants close examination, particularly in orthopaedics where obesity and surgical intervention often overlap, and when the long-term effects of GLP-1 RA exposure on bone and joint health remain poorly understood.” At the same time, researchers are examining how GLP-1 use may affect recovery rates after orthopaedic surgery. “Within orthopaedics, there has been relatively little research on how GLP-1 use affects postoperative outcomes,” said Haroun Haque, a third-year medical student at SUNY Downstate College of Medicine and primary investigator of “Rising Use of GLP-1 Agonists Across Common Orthopaedic Procedures and Their Association with Improved Postoperative Outcomes.” “Given how dramatically the use of these medications has increased,especially since 2019,it is important to understand how these may influence surgical recovery and complications.” STUDY OVERVIEW AND OUTCOMES Rising use of GLP-1 agonists across common orthopaedic procedures and association with improved postoperative outcomesThis retrospective cohort study used a national claims database to identify patients with obesity-related diagnosis codes who underwent 10 of the most common orthopaedic surgeries from 2010 to 2023. The research team evaluated national trends in preoperative GLP-1RA use and assessed associations with postoperative medical and surgical complications. Procedures included total hip arthroplasty (THA), total knee arthroplasty (TKA), anterior cruciate ligament repair, hip cephalomedullary nail, hip hemiarthroplasty, lumbar fusion, total shoulder arthroplasty, carpal tunnel release, distal radius open reduction internal fixation (ORIF), and ankle ORIF. Analyses were stratified by obesity class (BMI = 30-39.9 and BMI ≥ 40). The study found a consistent increase in GLP-1 and semaglutide use among patients undergoing these procedures, with a marked rise since 2019. Across multiple major orthopaedic procedures, use of GLP-1 and semaglutide was associated with significantly lower odds of postoperative emergency department visits, without an increased surgical risk. GLP-1 use was also associated with significantly lower surgical site infection rates among patients undergoing TKA and THA. While revision rates were lower among GLP-1 users undergoing TKA, they increased among patients undergoing carpal tunnel release. GLP receptor agonist use linked to increased risk of osteoporosis, gout and osteomalacia in adults with Type 2 diabetes and obesity
Wajahath and his research team performed a retrospective cohort study to evaluate the five-year risk of osteoporosis, gout and osteomalacia in patients with Type 2 diabetes and obesity (BMI ≥30 kg/m²) treated with GLP-1 RAs. The team used a large, multi-institutional electronic medical record–derived database to compare patients treated with GLP1-RA with matched controls. After matching for age, sex, race, BMI, hemoglobin A1c, tobacco use and comorbid conditions, such as chronic kidney disease, rheumatoid arthritis and baseline osteoporosis, the cohort sizes were 73,483 patients with balanced baseline characteristics. After five years, patients taking GLP-1RAs demonstrated:
- A significantly increased risk of osteoporosis compared to controls [4.1% vs. 3.2%; risk ratio (RR) 1.29, 95% control incidence (CI) 1.22–1.36; p<0.001].
- A higher incidence of gout among GLP-1 RA users (7.4% vs. 6.6%; RR 1.12, 95% CI 1.08–1.16; p<0.001).
- The greatest relative risk increase was observed for osteomalacia (0.2% vs. 0.1%; RR 2.55, 95% CI 1.83–3.55; p<0.001).
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level to best treat patients in their daily practices. AAOS is the source for information on bone and joint conditions, treatments and related musculoskeletal healthcare issues; and it leads the healthcare discussion on advancing quality. Follow the AAOS on Facebook, X, LinkedIn and Instagram. SOURCE American Academy of Orthopaedic Surgeons
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