2026 COA: GLP-1 Receptor Agonists in Hip and Knee Arthroplasty .

12 studies comprising of 100 244 patients undergoing primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) were included in this systematic review and meta-analysis evaluating the impact of perioperative glucagon-like peptide-1 receptor agonist (GLP-1RA) use. Pooled outcomes included periprosthetic joint infection (PJI), periprosthetic fracture, readmission, revision surgery, venous thromboembolism, aspiration events, and length of stay. GLP-1RA use was associated with lower rates of 90-day PJI, reduced 90-day readmissions, and lower revision rates following THA. However, GLP-1RA use was also associated with an increased risk of periprosthetic fracture at one year, particularly following TKA. Overall, GLP-1RAs appear safe and may improve several short-term arthroplasty outcomes, although potential long-term fracture risks require further investigation.