GLP-1s: Existential Threat to Arthroplasty Volume

 

GLP-1s appear to be more than weight loss drugs, potentially offering direct joint protection and dramatically reducing surgical risk. 

 

By the numbers



Recent research demonstrates significant clinical benefits across multiple measures:

 

• 40% of obese patients with known hip arthritis prescribed a GLP-1 showed a reduced risk of hip replacement within one year, based on data from 239,000+ patients.

• 25% of obese patients with known knee arthritis on a GLP-1 demonstrated a reduced risk of knee replacement within one year. 

• 1.0% versus 1.8% represents the prosthetic joint infection rates in morbidly obese patients on GLP-1s compared to those not on them – nearly half the risk. Readmissions also dropped from 8.9% to 5.3%.

 

Bottom line

 

As GLP-1 adoption grows, orthopedic programs should expect meaningful declines in both primary arthroplasty volume and post-operative complications.

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Why Morbidity, Not Fusion Rates, Separates Winners in Foot and Ankle Surgery

by Vince Vacketta, DPM

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The allograft space in foot and ankle fusion is crowded and confusing. Every company has a portfolio of products, and every product claims to be “best.” But what moves the needle in fusion?

 

The evidence

 

An April 2026 propensity-matched TriNetX study compared iliac crest autograft to rhPDGF-BB. Consistent with existing literature, key findings included:

 

• rhPDGF-BB is noninferior to autograft, meaning it demonstrates equivalent performance.

• There was no difference in union rates, revision, infection, or complications.

 

Counterpoint: Why not BMP-2?

 

BMP-2 has no foot and ankle products. It is used off-label and carries risks, including ectopic bone formation, swelling, and wound issues.

 

Why don’t more grafts contain rhPDGF-BB?

 

rhPDGF-BB requires drug–device biologic approval at the PMA level, requiring expensive trials and specialized manufacturing. Few companies enter this space.

 

Final points

 

What moves the needle in fusion success isn’t fusion rate

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First Metatarsophalangeal Joint (MTPJ) Arthrodesis for Hallux Values: Key Findings

 

For severe hallux values deformity, MTPJ arthrodesis offers definitive correction, but outcome data is sparse.

 

The study

 

A single-center retrospective case series between 2016–2021, reviewed 62 feet with a mean preoperative hallux valgus angle of 40.2° and intermetatarsal angle of 15.9°.

 

• Researchers found that patient-reported outcomes improved significantly by 26 weeks. 

• Foot function composite scores (MOxFQ) improved by 33.0 points.

• Quality-of-life scores (EQ5D time trade-off) improved by 0.217 points (P < .001).

• Improvements were sustained at two years, postoperatively.

 

The concern

 

Nearly one in five patients experienced complications: 

 

• 9.7% non-union rate

• 11.3% reported persistent pain

• 4.8% required later hardware removal

 

First MTPJ arthrodesis delivers durable, measurable functional gains, but clinicians must weigh a clinically significant complication burden in preoperative planning and informed consent.