GLP-1 Drugs Show Mixed Impact on Musculoskeletal Health and Surgical Outcomes — American Academy of Orthopaedic Surgeons

Event summary

Two studies presented at the 2026 AAOS Annual Meeting reveal GLP-1 receptor agonists (GLP-1 RAs) may improve short-term postoperative outcomes but increase long-term musculoskeletal risks.
A retrospective cohort study found GLP-1 RA users had higher five-year risks of osteoporosis (4.1% vs. 3.2%), gout (7.4% vs. 6.6%), and osteomalacia (0.2% vs. 0.1%).
Another study showed GLP-1 RAs were associated with lower postoperative emergency department visits and surgical site infections in major orthopedic procedures like TKA and THA.
The research analyzed data from over 73,000 patients across multiple institutions.

The big picture

GLP-1 receptor agonists have seen rapid adoption for obesity and Type 2 diabetes management, but these studies highlight the need to balance their cardiometabolic benefits against emerging musculoskeletal risks. The findings come as long-term data becomes available for patients who began using these medications in the mid-2010s, creating new considerations for both prescribers and surgical specialists.

What we're watching

Long-Term Safety Monitoring: How GLP-1 RA manufacturers will address emerging musculoskeletal risks through labeling changes or additional studies.
Surgical Protocol Adjustments: Whether orthopedic surgeons will modify preoperative assessments for patients on GLP-1 RAs based on these findings.
Regulatory Scrutiny: The pace at which health authorities may require updated safety information for widely prescribed GLP-1 medications.