Do Revisions in Rotator Cuff Repair Decline With GLP-1 Use? - Summary - MDSpire
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Do Revisions in Rotator Cuff Repair Decline With GLP-1 Use?
Preoperative use was associated with fewer revisions and no increase in short-term complications among patients with obesity, although benefits appeared concentrated in select subgroups.
To evaluate the impact of preoperative glucagon-like peptide-1 receptor agonists on revision rates and complications in patients with obesity undergoing arthroscopic rotator cuff repair.
Approach:
Study Design: Retrospective analysis using the TriNetX electronic health record database to identify patients with obesity who underwent primary arthroscopic rotator cuff repair prior to June 2023.
Patient Matching: Patients receiving GLP-1 receptor agonists were propensity matched 1:1 with those who had never received the therapy, resulting in matched cohorts of 1,183 patients each.
Outcome Evaluation: Evaluated medical complications and emergency department utilization at 90 days, as well as retear, revision surgery, and conversion-to-arthroplasty rates at 1 and 2 years post-surgery.
Key Findings:
Lower revision rates for left-sided repairs in patients receiving GLP-1 receptor agonists: 2% at 1 year and 4% at 2 years compared to 7% and 8% in controls.
No significant differences in revision rates for right-sided repairs.
Lower retear rates among female patients undergoing left-sided repairs: 19% vs. 31% at 1 year and 20% vs. 34% at 2 years.
No significant differences in retear rates in the overall cohort or among male patients and right-sided repairs.
Short-term safety outcomes were similar between groups with no significant differences in complications.
Interpretation:
Limitations:
Retrospective study design with reliance on administrative coding data, which may lead to inaccuracies.
Lack of information on tear size, tissue quality, surgical technique, rehabilitation protocols, and imaging-confirmed healing.
Patients with preoperative vitamin D deficiency had higher postoperative pain scores and opioid use after mastectomy, including more than triple the odds of moderate to severe pain within 24 hours of surgery.
