Hormonal
In obese patients without preexisting osteoarthritis, GLP-1 receptor agonist use is associated with an increased incidence of new hip and knee OA diagnoses and conversion to total knee arthroplasty within one year.
If you are obese but do not have existing hip or knee osteoarthritis, using a GLP-1 receptor agonist is associated with a higher risk of being diagnosed with new OA or needing knee replacement surgery within a year. This is unexpected given the weight loss benefits, and researchers suggest it might be due to increased physical activity stressing the joints. If you are considering these medications, discuss your joint health history with your doctor, and be aware that the benefits for joint health may primarily apply to those who already have OA.
In patients without preexisting OA, GLP-1-RA use was associated with an increased incidence of hip OA (0.9% vs 0.7%; HR, 1.4; 95% CI, 1.2 to 1.6), knee OA (2.1% vs 1.9%; HR, 1.3; 95% CI, 1.2 to 3.1), major joint injections (2.2% vs 1.8%; HR, 1.4; 95% CI, 1.3 to 1.5), and TKA (0.09% vs 0.04%; HR, 2.6; 95% CI, 1.6 to 4.3).
Why this rating
Level of evidence 3 (cohort study) with large sample size but retrospective design and potential confounding.
Source
The Impact of Contemporary Glucagon-like Peptide-1 Receptor Agonists on the Onset, Severity, and Conversion to Arthroplasty in Hip and Knee Osteoarthritis
Joshua R. Porto et al. · Orthopaedic Journal of Sports Medicine · 2025
DOI 10.1177/23259671241297157
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