Impact of Ozempic, Wegovy on orthopedics needs more study, Rothman surgeon says

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Ozempic and Wegovy, GLP-1 weight loss drugs, have risen in popularity and are grabbing the attention of orthopedic surgeons.

Experts are predicting that an already projected uptick in total joint replacements could come sooner as people lose weight with the drug. A trial for Wegovy shows patients lost 15% of their body weight on average.

The drugs are still newer to the market, but research is already measuring its impact on orthopedics as well as anesthesia, Max Courtney, MD, of Philadelphia-based Rothman Orthopaedic Institute said.

"The downside of these medications is that it delays gastric emptying, and that's how it helps make you lose weight because you feel fuller," Dr. Courtney, chief of joint replacement at Rothman said. "But some of our patients may need to skip a dose or they need their NPO time [before surgery] to be longer. Our anesthesiology colleagues are actively doing research into the effect with the anesthesia. We're doing active research. We have several studies ongoing at the Rothman Institute looking at the effect of these medications after joint replacement."

But solutions extend beyond numbers on the scale alone, he cautioned. He's already seen how significant weight loss methods have affected outcomes for patients who had gastric bypass.

"I would caution that it might not just be obesity," Dr. Courtney said. "Malnutrition plays a role. We saw this with gastric bypass patients. We thought patients that had gastric bypass, because they were going to lose so much weight, their outcomes and infection rates were going to be better after joint replacement. But we found that that wasn't the case because for gastric bypass patients, some of them can have a state of malnutrition. It could be the nutrition that plays a role with the wound healing as much as the metabolic syndrome from obesity, so further studies are still needed." 

Dr. Courtney doesn't expect Ozempic, Wegovy and similar drugs to change his practice but he hopes that they can help patients.

"We're not denying people care at the Rothman Institute," he said. "We're just trying to optimize them. If these medications are going to be able to help patients lose weight, so that we can reduce their infection and complication rate, that would certainly be very helpful."

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