A study presented at the 2025 Annual Meeting of the American Academy of Orthopaedic Surgeons examined the relationship between the patient’s last dose of Ozempic, a common GLP-1, and anesthesia-related complications during total knee and hip arthroplasties.
Here are 10 takeaways from the study:
1. The study, “Optimal Timing for Cessation of GLP-1 Agonist Before Elective Total Hip and Knee Arthroplasty,” obtained data from the TriNetX Research Network, a multi-institutional national aggregated database, to identify patients who underwent TKA or THA from Jan. 1, 2018, to Jan. 1, 2023.
2. Patients who used Ozempic were categorized into cohorts based on when they discontinued Ozempic before surgery:
- 30 days prior to surgery: 482 patients
- 14 days prior to surgery: 591 patients
- Seven days prior to surgery: 680 patients
- Five days prior to surgery: 758 patients
- Three days prior to surgery: 777 patients
- One day prior to surgery: 706 patients
- Did not stop Ozempic prior to surgery: 170 patients
3. These patients were examined against a control group of 206,005 with no history of Ozempic use.
4. Stopping Ozempic use three to five days prior to surgery emerged as an independent risk factor for delayed emergence from anesthesia.
5. The patients who stopped Ozempic use seven, 14 or 30 days prior to surgery had no independent risk factor for delayed emergence from anesthesia.
6. The patients who stopped Ozempic use three to seven days prior to surgery also had an independent risk factor for aspiration, whereas the 14- and 30-day cohorts did not.
7. Stopping Ozempic use three to five days before surgery was also identified as a risk factor for aspiration pneumonitis, while the seven-, 14- and 30-day cohorts did not have this risk factor.
8. Stopping Ozempic use three to seven days prior to surgery was an independent risk factor for conversation to intubation, while the 14- and 30-day cohorts had no independent risk factor for conversation to intubation.
9. Patients who did not stop Ozempic use at all prior to surgery were at the highest level of risk for all complications studied.
10. “This research provides additional evidence to suggest that discontinuing GLP-1 agonists at least 14 days before total joint replacement surgery is optimal to reduce the risk of delayed emergence from anesthesia, aspiration events, aspiration pneumonitis and conversion to intubation,” said John Crockarell, MD, total joint arthroplasty surgeon at Campbell Clinic Orthopaedics in Memphis, Tenn., in a March 10 news release about the study. “This study offers a practical guideline for surgeons managing patients on GLP-1 agonists in the perioperative period for lower extremity THA and TKA procedure.”
