Objective:

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.
• Observed benefits primarily limited to left-sided repairs, potentially reflecting coding limitations.

Conclusion:

Sources:

• Arthroscopy, Editorial