- Hip replacements are frequent in circumstances similar to osteoarthritis, and weight problems is a widely known threat issue.
- Individuals who have weight problems and obtain a hip alternative usually tend to expertise issues after the process than these at a wholesome weight.
- New analysis stories folks taking semaglutide — the energetic ingredient in Wegovy and Ozempic — had related or improved postoperative outcomes after a complete hip alternative than those that didn’t take the drug.
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Individuals who have osteoarthritis or rheumatoid arthritis may have a complete hip alternative, in addition to anybody experiencing injury to their hip joint.
As with every surgical procedure, there are some dangers of issues. Previous research present that individuals who have weight problems and obtain a complete hip arthroplasty usually tend to expertise issues in comparison with those that are at a wholesome weight.
Because of this, medical doctors could recommend an individual who has weight problems lose some weight earlier than having hip alternative surgical procedure.
Now, two research lately introduced on the American Academy of Orthopaedic Surgeons’ 2024 Annual Assembly look at using
Researchers reported that folks taking semaglutide had related or improved postoperative outcomes after a complete hip alternative to those that didn’t take the drug.
In keeping with Dr. Matthew L. Magruder, a third-year resident at Maimonides Well being in Brooklyn, NY and lead writer of one of many introduced research, with the approval of semaglutide for the remedy of weight problems by the FDA in 2021, and the encompassing media consideration, it was clear that this remedy was going to blow up in reputation.
“On condition that lots of our sufferers present process complete hip arthroplasty [have obesity], it’s inevitable {that a} rising proportion might be taking it within the perioperative interval,” Dr. Magruder defined to Medical Information At this time.
“Subsequently, we figured it could be essential to evaluate the information we already had on its impact (on) complete hip arthroplasty. It will likely be more and more essential to grasp the impact of this remedy on our sufferers as orthopedic surgeons,” he mentioned.
“Particularly, for sufferers who [have obesity] and in continual ache as a consequence of hip osteoarthritis, it may be very onerous to shed weight to be able to be indicated for complete hip arthroplasty,” added Dr. Daniel Pereira, an orthopedic surgical procedure resident at Washington College Barnes-Jewish Hospital and co-lead writer of the second introduced research.
“[Having obesity] and [being] in ache makes it a lot tougher to burn energy by way of conventional means similar to train or calorie slicing. Nonetheless, the excessive threat for issues for [patients with obesity] receiving complete hip replacements makes it in order that many of those sufferers don’t obtain this process — for good purpose.”
— Dr. Daniel Pereira
“Thus, we have to perceive if there have been any results on the outcomes following complete hip arthroplasty in sufferers who took semaglutide when in comparison with controls,” Dr. Pereira advised MNT.
Dr. Pereira’s research examined hip alternative postoperative issues amongst sufferers with weight problems who used semaglutide in comparison with those that didn’t use the remedy.
Scientists recruited 616 folks in every cohort with a median BMI of 35.5. Upon evaluation, the researchers discovered postoperative issues after a hip alternative — together with hip arthroplasty revision, prosthesis an infection, and surgical website infections — had been related between folks have weight problems taking semaglutide in comparison with these not utilizing the drug.
Dr. Pereira mentioned they weren’t stunned by these findings.
“We hypothesized that sufferers who had been on semaglutide and obtained complete hip replacements would have the identical outcomes, for higher or worse, than those that maintained or misplaced weight by conventional means — we discovered this to be the case,” he defined.
“The implications are apparent — sufferers who in any other case could be at the next threat profile for this surgical procedure can take semaglutide to shed weight and be at a greater likelihood at an equal final result as anybody else. They don’t must obtain bariatric surgical procedure or undergo different extra rigorous technique of weight reduction to be able to be indicated for the process,” he added.
Dr. Magruder’s analysis evaluated whether or not diabetic sufferers taking semaglutide on the time of their hip alternative surgical procedure had fewer medical issues, fewer implant-related issues, fewer readmissions, and decrease prices than those that weren’t taking the remedy.
Researchers reported folks with diabetes taking semaglutide had decrease charges of readmission inside 90 days of their complete hip arthroplasty and decrease charges of prosthetic joint an infection in comparison with the management group.
“These findings weren’t anticipated however make sense given the remedy’s mechanism of motion,” Dr. Magruder defined. “Two of its identified actions are growing insulin secretion, thereby reducing blood glucose ranges and slowing gastric emptying, thereby reducing caloric consumption and reducing weight.”
“On condition that poorly managed diabetes and weight problems are impartial threat elements for prosthetic joint an infection, it is sensible that this remedy’s use would possibly lower its threat after complete hip arthroplasty,” he added. “Moreover, with much less prosthetic joint infections, it could comply with that there could be fewer readmissions.”
Scientists additionally discovered these taking semaglutide didn’t present statistically vital larger charges of issues in comparison with these not taking the drug. There was additionally no distinction between the 2 teams for every other implant-related complication, lengths of keep, same-day surgical prices, or 90-day episode of care prices.
After reviewing these research, Dr. Timothy Gibson, a board-certified orthopedic surgeon and medical director of the MemorialCare Joint Alternative Middle at Orange Coast Medical Middle in Fountain Valley, CA, advised MNT these findings gave him each emotions of pleasure and aid.
“It’s reassuring to know that sufferers with weight problems and diabetes who took semaglutide previous to hip alternative surgical procedure don’t have larger dangers, and in some circumstances have decrease dangers of complication,” Dr. Gibson continued. “Weight problems is a identified challenge for these present process hip alternative surgical procedure. We encourage sufferers with a really excessive BMI to shed weight earlier than continuing with surgical procedure to enhance their security profile.”
“Most, nonetheless, are unsuccessful, and sometimes the surgical procedure isn’t carried out,” he added. “This new class of medicines could open the door for a lot of extra [patients with obesity] to have the chance to take pleasure in the advantages of this sometimes very profitable surgical procedure and to renew a extra pain-free and energetic life-style.”
MNT additionally spoke with Dr. Gregg R. Klein, vice-chair of the Division of Orthopedic Surgical procedure at Hackensack College Medical Middle in New Jersey, about these two research.
Dr. Klein additionally expressed pleasure over these analysis outcomes.
“Traditionally, it’s well-known that weight problems and poor diabetic management have been vital threat elements for sufferers present process complete hip alternative,” he detailed. “It has been a problem for surgeons to optimize a affected person with these circumstances.”
“Using semaglutide has grow to be one other approach that physicians and surgeons may also help sufferers deal with weight problems and shed weight earlier than surgical procedure. Clinically we have now seen sufferers lose a major quantity of weight utilizing these drugs. Hopefully, the load loss will translate to much less issues and higher outcomes,” Dr. Klein added.